We explored the determinants of intention to adopt pre-exposure prophylaxis (PrEP) in HIV-care clinics in Colombia. Using qualitative methods and the Consolidated Framework for Implementation Research (CFIR), we identified facilitating and hindering organizational factors related to PrEP adoption. Organizations intending to adopt PrEP have a culture that supports PrEP, compatibility with clinic logistics, leadership support, and resources for provision. Our study demonstrates that the framework effectively identifies organizational factors to intervene and suggest implementation strategies to address barriers identified.