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Barriers Faced By Trans People, Sex Workers and Black African Women When Accessing PrEP

PrEP (pre-exposure prophylaxis) is a drug that reduces an individual’s chance of contracting HIV during sex. If taken as prescribed PrEP is approximately 99% effective. The client identified three target audiences who had low levels of uptake, but would benefit from using PrEP.

Investigate barriers that three target audiences face and develop recommendations to increase PrEP uptake.

Target Audiences:
Black African Women
Female Sex Workers
Trans and non-binary people

The first phase of research involved talking to stakeholders who worked in sexual health services across England to identify systemic barriers to PrEP uptake and to co-create data collection methods for phase 2.

Research methods and materials were produced using feedback from conversations with stakeholders. These materials included a screener questionnaire, demographic questionnaire and qualitative discussion guide which used the COM-B model as a framework.

The second phase of the project involved talking directly to people in the three target audiences to find out the barriers that they faced. We partnered with stakeholders in sexual health services to recruit participants for focus group discussions. We then provided training to these stakeholders so that they could collect data. This route was used because stakeholders had
established relationships with service users in the target audiences.

Focus group discussions were recorded and analysed using the COM-B framework for behaviour change.

The results showed individual-level, provider level and systemic-level barriers. Many barriers were consistent across the target audiences, while some barriers were unique to each audience.

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