Patient-provider communication and the role of PrEP coordinators: a qualitative analysis to improve HIV preventive care

Despite the proven effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV infection, significant disparities in its uptake persist, particularly among HIV priority populations in Arizona, USA. Patient-provider communication plays a vital role in facilitating PrEP access, especially when discussing sexuality and HIV-related risk behaviour. To explore how communication dynamics shape HIV prevention services, we conducted 24 semi-structured interviews with patients, healthcare providers, and PrEP coordinators. Guided by an adapted Patient-Provider Communication Framework, thematic analysis revealed intersecting barriers and facilitators across five domains: needs, beliefs, values, skills, and emotions. Patients reported logistical challenges, anticipated judgement, and the importance of trust and validation. Providers emphasised empathy, transparency, and inclusive care, while PrEP coordinators highlighted cultural competence, harm reduction, and emotional connection. Findings reveal a gap between providers' intentions and patients' perceptions, underscoring the important role of PrEP coordinators in bridging communication and building trust.