Start the Conversation: Development of a Training Program to Build OB/GYN Resident Capacity for PrEP Prescribing in Routine Care.

ObjectivesPre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool, yet uptake among women remains low, particularly for Black cisgender women. We aimed to identify determinants of PrEP implementation in OB/GYN residency clinic settings and develop an OB/GYN training program for a combined-care PrEP model in preparation for pilot testing.MethodsWe conducted a qualitative descriptive study using semi-structured, CFIR-guided qualitative interviews with OB/GYN residents, OB/GYN residency faculty, and PrEP providers in New Orleans, Louisiana. We then presented the findings in provider working group sessions to obtain feedback on the training program and adapt the program based on suggested modifications.ResultsWe conducted 12 interviews and 2 working group meetings. Participants perceived OB/GYN residents would be highly compatible PrEP providers given their focus on sexual health. They also identified provider barriers including limited knowledge, time constraints, and care discontinuity due to resident rotation blocks. Working group providers emphasized the need for practical training resources, clear clinical protocols, and a designated PrEP champion.ConclusionParticipants and working group providers viewed OB/GYN resident clinics as an acceptable setting for implementing and piloting a PrEP program. We finalized the scalable, provider-informed training model-"Start the Conversation"-to support PrEP integration into routine OB/GYN care at resident clinics.