Provider Preferences on Existing and Potential Future Biomedical HIV Prevention Products: A Qualitative Study in the United States, Thailand, and South Africa

Several forms of HIV pre-exposure prophylaxis (PrEP) are approved, prescribed off-label, or in development in the United States, including daily oral tablets, long-acting injectable cabotegravir (CAB-LA), removable implants, and rectal tenofovir products. To understand how health care providers prioritize among these options, 30 providers from the United States, Thailand, and South Africa completed online surveys, and 10 participated in in-depth interviews. Providers shared their perspectives on current and emerging PrEP products, key informational needs for gay and bisexual men, and preferred educational strategies. When asked to rank PrEP options if all were simultaneously available, providers most often prioritized removable implants (N = 3), daily oral PrEP (N = 3), CAB-LA (N = 1), and rectal douches/enemas (N = 1), while others (N = 2) emphasized patient preference. Overall, providers noted that each product has unique advantages and expressed support for digital shared decision-making tools to enhance patient-provider communication about PrEP selection.