Provider Perspectives on Group PrEP Care for Sex Workers: A Pre-implementation Study in a U.S. Midwestern Community Health Center

Reducing new HIV infections is crucial. Sex workers continue to face disparities in both HIV infection rates and inadequate prevention care. Stigma, criminalization, and financial instability hinder access to vital HIV prevention methods, including Pre-exposure Prophylaxis (PrEP). Evidence-based, community-centered PrEP care may help address these issues. An evidence-based group PrEP care model, Centering PrEP (C-PrEP +), could empower communities and reduce healthcare burdens. This study explored care professionals' perspectives on barriers and facilitators of C-PrEP + for sex workers. Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, we aimed to develop a pilot implementation plan for C-PrEP + . Individual interviews were held with care professionals at a U.S. Midwestern Community Health Center serving sex workers. To reflect the diverse roles and backgrounds of participants, we interviewed 14 healthcare professionals, including care providers, patient navigators, and billing specialists. Guided by a semi-structured interview guide, we sought care providers' views on obstacles and enablers related to prescribing PrEP and implementing group PrEP care for sex workers. Using Dedoose, we used directed content analysis to systematically explore their perspectives about C-PrEP + using predefined constructs from the EPIS framework to guide coding and interpretation. Major themes included healthcare for sex workers, challenges in standard PrEP care, perceptions of Centering PrEP, and barriers and facilitators for implementing C-PrEP + . Participants viewed group PrEP care as a means to foster patient-centered approaches and strengthen community ties, while addressing the demands of care. Thoughtful integration of C-PrEP + into clinics may be a promising strategy to improve HIV prevention for sex workers.