Perceptions of Pre-Exposure Prophylaxis Among American Indians

American Indians have seen a rise in the transmission of HIV infections compared to other racial and ethnic groups. Pre-exposure prophylaxis (PrEP), which is the use of antiviral medications to prevent HIV, there is insufficient literature to describe the acceptability, attitudes, or willingness to utilize PrEP by American Indians. The purpose of this descriptive qualitative study, guided by the health belief model, was to explore perceptions of PrEP among American Indians. Open-ended semi structured questions were used to interview eight participants to ascertain perceptions of PrEP to prevent HIV infections. Using coding and thematic analysis, four themes were identified: (a) advantages of PrEP, (b) barriers to implementation of PrEP, (c) facilitators to implementation of PrEP, and (d) female-specific concerns regarding PrEP. The findings and recommendations of the study have the potential to support positive social change by decreasing the incidence, prevalence, and mortality associated with HIV among American Indians given their positive perception of PrEP. Addressing barriers to the implementation of PrEP among American Indians can be remedied by educating American Indians about their risk factors for HIV, available options to decrease risk, provide referrals to providers who are offering PrEP. Future research is needed to validate these findings in a larger sample and to characterize further the facilitators and barriers to aid in implementing PrEP among American Indian tribes.