Barriers and facilitators to the implementation of HIV pre-exposure prophylaxis in primary health care.

OBJECTIVE: To analyze the barriers and facilitators to the implementation of Pre-Exposure Prophylaxis (PrEP) for the Human Immunodeficiency Virus (HIV) through the experiences of Primary Healthcare workers. METHOD: Qualitative study with semi-structured interviews conducted between April and July 2022 with 16 healthcare professionals working in Primary Health Care Units in the city of São Paulo, Brazil. The data were fully transcribed and analyzed using content analysis, supported by the webQDA® software and theoretical grounding based on vulnerability in health. RESULTS: Two categories emerged related to the barriers and facilitators of the implementation of Pre-Exposure Prophylaxis. Among the barriers, work overload, structural limitations, and the stigma associated with the HIV were highlighted. Sensitized professionals and continuing education were identified as decisive factors in expanding access to the strategy. Facilitators included multidisciplinary work, institutional training, engagement with users, and coordination with programs aimed at the lesbian, gay, bisexual, and transgender population. CONCLUSION: Pre-Exposure Prophylaxis is advancing in primary care but faces obstacles. Its implementation requires qualified teams and inclusive practices in the Unified Health System, capable of expanding access, adherence, and monitoring of users, especially those most vulnerable to HIV.