BACKGROUND: Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. OBJECTIVE: To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. DESIGN: Cross-sectional online survey conducted in April and May 2015. RESPONDENTS: Members of a national professional organization for academic primary care physicians (n = 266). MAIN MEASURES: PrEP awareness, PrEP adoption (ever prescribed or referred a patient for PrEP [yes/no]), provider and practice characteristics, and self-rated knowledge, attitudes, and beliefs associated with adoption. KEY RESULTS: The survey response rate was 8.6 % (266/2093). Ninety-three percent of respondents reported prior awareness of PrEP. Of these, 34.9 % reported PrEP adoption. In multivariable analysis of provider and practice characteristics, compared with non-adopters, adopters were more likely to provide care to more than 50 HIV-positive patients (vs. 0, aOR = 6.82, 95 % CI 2.06-22.52). Compared with non-adopters, adopters were also more likely to report excellent, very good, or good selfrated PrEP knowledge (15.1 %, 33.7 %, 30.2 % vs. 2.5 %, 18.1 %, 23.8 %, respectively; p < 0.001) and to perceive PrEP as extremely safe (35.1 % vs. 10.7 %; p = 0.002). Compared with non-adopters, adopters were less likely to perceive PrEP as being moderately likely to increase risk behaviors ("risk compensation") (12.8 % vs. 28.8 %, p = 0.02). CONCLUSIONS: While most respondents were aware of PrEP, only one-third of PrEP-aware PCPs reported adoption. Adopters were more likely to have experience providing HIV care and to perceive PrEP as extremely safe, and were less likely to perceive PrEP use as leading to risk compensation. To enhance PCP adoption of PrEP, educational efforts targeting PCPs without HIV care experience should be considered, as well as training those with HIV care experience to be PrEP "clinical champions". Concerns about safety and risk compensation must also be addressed.

Background New York City (NYC) was hard-hit by the SARS-CoV-2 pandemic and is also home to a large population of people with HIV (PWH). Methods We matched lab-confirmed COVID-19 case and death data reported to the NYC Health Department as of June 2, 2020, against the NYC HIV surveillance registry. We describe and compare the characteristics and COVID-19-related outcomes of PWH diagnosed with COVID-19 with all NYC PWH and with all New Yorkers diagnosed with COVID-19. Results Through June 2, 204,583 NYC COVID-19 cases were reported. The registry match identified 2,410 PWH with diagnosed COVID-19 eligible for analysis (1.06% of all COVID-19 cases). Compared with all NYC PWH and all New Yorkers diagnosed with COVID-19, a higher proportion of PWH with COVID-19 were older, male, Black or Latino, and living in high-poverty neighborhoods. At least one underlying condition was reported for 58.9% of PWH with COVID-19. Compared with all NYC COVID-19 cases, a higher proportion of PWH with COVID-19 experienced hospitalization, intensive care unit admission and/or death; most PWH who experienced poor COVID-19-related outcomes had CD4 &lt;500 cells/µL. Conclusions Given NYC HIV prevalence is 1.5%, PWH were not overrepresented among COVID-19 cases. However, compared with NYC COVID-19 cases overall, a greater proportion of PWH had adverse COVID-19-related outcomes, perhaps because of a higher prevalence of factors associated with poor COVID-19 outcomes. Given the pandemic’s exacerbating effects on health inequities, HIV public health and clinical communities must strengthen services and support for people living with and affected by HIV.

Pre-exposure prophylaxis for HIV (PrEP) is recommended for people who inject drugs (PWID). Despite their central role in disease prevention, willingness to prescribe PrEP to PWID among primary care physicians (PCPs) is largely understudied. We conducted an online survey (April – May 2015) of members of a society for academic general internists regarding PrEP. Among 250 respondents, 74% (n=185) of PCPs reported high willingness to prescribe PrEP to PWID. PCPs were more likely to report high willingness to prescribe PrEP to all other HIV risk groups (p’s<0.03 for all pair comparisons). Compared with PCPs delivering care to more HIV-infected clinic patients, PCPs delivering care to fewer HIV-infected patients were more likely to report low willingness to prescribe PrEP to PWID (Odds Ratio [95% CI]= 6.38 [1.48–27.47]). PCP and practice characteristics were not otherwise associated with low willingness to prescribe PrEP to PWID. Interventions to improve PCPs’ willingness to prescribe PrEP to PWID are needed.

Section 1 Diagnoses of HIV Infection and Diagnoses of Infection Classified as Stage 3 (AIDS) 1a Diagnoses of HIV infection, by year of diagnosis and selected characteristics, 2012-2017-United States 1b Diagnoses of HIV infection, by year of diagnosis and selected characteristics, 2012-2017-United States and 6 dependent areas 2a Stage 3 (AIDS), by year of diagnosis and selected characteristics, 2012-2017 and cumulative-United States 2b Stage 3 (AIDS), by year of diagnosis and selected characteristics, 2012-2017 and cumulative-United States and 6 dependent areas 3a Diagnoses of HIV infection, by race/ethnicity and selected characteristics, 2017-United States 3b Diagnoses of HIV infection, by race/ethnicity and selected characteristics, 2017-United States and 6 dependent areas 4a Stage 3 (AIDS), by race/ethnicity and selected characteristics, 2017-United States 4b Stage 3 (AIDS), by race/ethnicity and selected characteristics, 2017-United States and 6 dependent areas 5a Diagnoses of HIV infection among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States 5b Diagnoses of HIV infection among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States and 6 dependent areas 6a Stage 3 (AIDS) among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States 6b Stage 3 (AIDS) among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States and 6 dependent areas 7a Diagnoses of HIV infection attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States 7b Diagnoses of HIV infection attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States and 6 dependent areas 8a Diagnoses of HIV infection attributed to injection drug use, by selected characteristics, 2012-2017-United States 8b Diagnoses of HIV infection attributed to injection drug use, by selected characteristics, 2012-2017-United States and 6 dependent areas 9a Diagnoses of HIV infection attributed to heterosexual contact, by selected characteristics, 2012-2017-United States 9b Diagnoses of HIV infection attributed to heterosexual contact, by selected characteristics, 2012-2017-United States and 6 dependent areas 10a Stage 3 (AIDS) attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States 10b Stage 3 (AIDS) attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States and 6 dependent areas  HIV Surveillance Report 4 Vol. 29 15 Stage 3 (AIDS) among children aged <13 years, by year of diagnosis, 1992-2017-United States and 6 dependent areas 16 Diagnoses of HIV infection among adult and adolescent Hispanics/Latinos, by transmissio...