Using epidemiological data to explore the impact of mental health and substance use disorder treatment facilities and family planning clinic availability on pre-exposure prophylaxis use for women in the U.S

Dion C Allen; Silvia E Rabionet; Sannisha K Dale; Carmen D Zorrilla; Georgina Silva-Suarez; Ioana Popovici

doi:10.1080/09540121.2025.2534112

Using epidemiological data to explore the impact of mental health and substance use disorder treatment facilities and family planning clinic availability on pre-exposure prophylaxis use for women in the U.S

Dion C Allen
, Silvia E Rabionet
, Sannisha K Dale
, Carmen D Zorrilla
, Georgina Silva-Suarez
, Ioana Popovici

Research output: Contribution to journal › Article › peer-review

Abstract

Ending the HIV epidemic by 2030 is partly dependent on preexposure prophylaxis (PrEP), but usage has been markedly low among women. This study sought to determine if access to mental health and substance use disorder treatment, and family planning clinics have an impact on women's PrEP uptake. Using epidemiological data from publicly available data sources, we employed a difference-in-differences design to quantify the effect of the availability of these facilities on PrEP rate and PrEP-to-need ratio across all 50 states. We found that mental health and substance use disorder treatment had a small effect on PrEP rate for males 0.9% (0.888), but there was no effect on female PrEP outcomes. The availability of family planning clinics was found to be associated with an 8.1% (-0.664) decrease in PrEP rate among females. We concluded that PrEP is not being adequately implemented in mental health and substance use disorder treatment, and family planning clinics, suggesting missed opportunities. These facilities are excellent venues for promoting PrEP adoption as they already reach women susceptible to HIV. The focus should be on embedding PrEP-related care into existing standards of care in these settings to increase PrEP uptake among women who would benefit from PrEP.

Original language	English
Pages (from-to)	1271-1282
Number of pages	12
Journal	AIDS Care
Volume	37
Issue number	8
DOIs	https://doi.org/10.1080/09540121.2025.2534112
State	Published - Aug 2025

Funding

This study was supported by the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH) – National Institute on Drug Abuse as a Center of Excellence under grant number P30DA040500, and the University of Puerto Rico, Mentoring Institute for HIV and Mental Health Research – National Institute of Mental Health (NIMH) under Grant number R25MH08361. Author D. C. A. was also supported by the Culturally-focused HIV Advancements through the Next Generation for Equity (CHANGE) Training Program under grant number T32MH126772 funded by NIMH. Author S. K. D. was funded by R01MH121194 and R01MH134269 from the NIMH.

Keywords

Humans
Female
Pre-Exposure Prophylaxis/statistics & numerical data
United States/epidemiology
HIV Infections/prevention & control
Substance-Related Disorders/therapy
Family Planning Services/statistics & numerical data
Male
Health Services Accessibility/statistics & numerical data
Adult
Mental Disorders/therapy
Anti-HIV Agents/therapeutic use
Mental Health Services
Middle Aged

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10.1080/09540121.2025.2534112

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Allen, D. C., Rabionet, S. E., Dale, S. K., Zorrilla, C. D., Silva-Suarez, G., & Popovici, I. (2025). Using epidemiological data to explore the impact of mental health and substance use disorder treatment facilities and family planning clinic availability on pre-exposure prophylaxis use for women in the U.S. AIDS Care, 37(8), 1271-1282. https://doi.org/10.1080/09540121.2025.2534112

Using epidemiological data to explore the impact of mental health and substance use disorder treatment facilities and family planning clinic availability on pre-exposure prophylaxis use for women in the U.S. / Allen, Dion C; Rabionet, Silvia E; Dale, Sannisha K et al.
In: AIDS Care, Vol. 37, No. 8, 08.2025, p. 1271-1282.

Research output: Contribution to journal › Article › peer-review

Allen, DC, Rabionet, SE, Dale, SK, Zorrilla, CD, Silva-Suarez, G & Popovici, I 2025, 'Using epidemiological data to explore the impact of mental health and substance use disorder treatment facilities and family planning clinic availability on pre-exposure prophylaxis use for women in the U.S', AIDS Care, vol. 37, no. 8, pp. 1271-1282. https://doi.org/10.1080/09540121.2025.2534112

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abstract = "Ending the HIV epidemic by 2030 is partly dependent on preexposure prophylaxis (PrEP), but usage has been markedly low among women. This study sought to determine if access to mental health and substance use disorder treatment, and family planning clinics have an impact on women's PrEP uptake. Using epidemiological data from publicly available data sources, we employed a difference-in-differences design to quantify the effect of the availability of these facilities on PrEP rate and PrEP-to-need ratio across all 50 states. We found that mental health and substance use disorder treatment had a small effect on PrEP rate for males 0.9\% (0.888), but there was no effect on female PrEP outcomes. The availability of family planning clinics was found to be associated with an 8.1\% (-0.664) decrease in PrEP rate among females. We concluded that PrEP is not being adequately implemented in mental health and substance use disorder treatment, and family planning clinics, suggesting missed opportunities. These facilities are excellent venues for promoting PrEP adoption as they already reach women susceptible to HIV. The focus should be on embedding PrEP-related care into existing standards of care in these settings to increase PrEP uptake among women who would benefit from PrEP.",

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