Evaluating family physicians’ willingness to prescribe PrEP

Villeneuve, France; Cabot, Jean-Michel; Eymard-Duvernay, Sabrina; Visier, Laurent; Tribout, Vincent; Perollaz, Cyril; Reynes, Jacques; Makinson, Alain

doi:10.1016/j.medmal.2020.02.003

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…The top three barriers that impacted our Australian GPs participants prescribing of PrEP were difficulty identifying clients who would benefit from PrEP, lack of knowledge regarding PrEP, and lack of time to adequately counsel regarding PrEP. These results are comparable with the literature, with the main barriers identified in studies as lack of knowledge regarding PrEP and difficulty identifying clients at risk of HIV (8, 10, 11, 12, 19). Difficulty identifying clients who would benefit from PrEP could be addressed by having GP clinics collect certain demographics as part of client registration.…”

Section: Discussionsupporting

confidence: 88%

“…Past studies have identified several barriers to PrEP prescribing among GPs. Barriers include lack of knowledge regarding PrEP, inability to identify clients at risk of HIV, and concern that PrEP use may increase the incidence of other STIs (8, 9, 10, 11, 12). An Australian GP questionnaire found the main barriers to PrEP prescribing were lack of experience with antiretrovirals and lack of guidelines for prescription (13).…”

Section: Introductionmentioning

confidence: 99%

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Prescribing pre-exposure prophylaxis (PrEP) for HIV prevention: A cross-sectional survey of General Practitioners in Australia

Wu,

Fairley,

Grace

et al. 2024

Preprint

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Background Pre-exposure prophylaxis (PrEP) is a safe and effective medication for preventing HIV acquisition. We examined Australian general practitioners (GP) knowledge of PrEP efficacy, characteristics associated with ever prescribing PrEP, and barriers to prescribing. Methods We conducted an online cross-sectional survey of GPs working in Australia between April and October 2022. We performed univariable and multivariable logistic regression analyses to identify factors associated with: 1) the belief that PrEP was at least 80% efficacious; and 2) ever prescribed PrEP. We asked participants to rate the extent to which barriers affected their prescribing of PrEP. Results 407 participants with a median age of 38 years (interquartile range 33-44). Half of the participants (50%, 205/407) identified how to correctly take PrEP, 63% (258/407) had ever prescribed PrEP, and 45% (184/407) felt confident with prescribing PrEP. Ever prescribing PrEP was associated with younger age (AOR 0.97, 95%CI: 0.94-0.99), extra training in sexual health (AOR 2.57, 95%CI: 1.54-4.29), and being a S100 Prescriber (OR 2.95, 95%CI: 1.47-5.90). The main barriers to prescribing PrEP included: Difficulty identifying clients who require PrEP/relying on clients to ask for PrEP (76%, 310/407), Lack of knowledge about PrEP (70%, 286/407), and Lack of time (69%, 281/407). Conclusion Less than half of our GP respondents were confident in prescribing PrEP, and most had difficulty identifying who would require PrEP. Specific training on PrEP, which focuses on PrEP knowledge, identifying suitable clients, and making it time efficient is recommended, with GPs being remunerated for their time.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Prescribing pre-exposure prophylaxis (PrEP) for HIV prevention: A cross-sectional survey of General Practitioners in Australia

Wu,

Fairley,

Grace

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Family physicians in our study differed, however, in their views on FPs' engagement in starting clients on PrEP and in providing follow-up care. Where previous quantitative studies mainly explored whether FPs would be willing to prescribe PrEP, our study thus provides a deeper understanding of their preferred degree of involvement in PrEP care ( 16 , 31 , 32 ). One central aspect that may influence such preferences, is preserving an acceptable cost-benefit balance in the FP practice.…”

Section: Discussionmentioning

confidence: 99%

How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium

et al. 2022

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Introduction:In Belgium, the provision of pre-exposure prophylaxis (PrEP) for HIV prevention is centralized in specialized HIV clinics. Engaging family physicians in PrEP care could help scale-up its delivery and reach underserved populations. The objective of this study was to gain insight into family physicians' self-perceived roles in providing PrEP.MethodsWe conducted 16 online group discussions with a total of 105 Flemish family physicians, between November 2020 and February 2021. A brief online questionnaire assessed their socio-demographics and experience with sexual health. We analyzed verbatim transcribed data using a grounded theory approach.ResultsDespite limited awareness and experience, participants reported a high willingness to be more actively involved in PrEP care. Four potential roles for the family physician in PrEP care were identified: acting as low-threshold entry point for advice; opportunistic case finding of PrEP candidates; initiating appropriate care for PrEP-eligible clients; and ensuring high-quality follow-up care for PrEP users. Participants framed each of these roles within their current activities and responsibilities as primary care providers. Yet, participants differed in their views on the concrete operationalization of these roles, and in the extent of their involvement in PrEP. Particular challenges were a lack of experience with antiretrovirals, perceived limited exposure to clients at high HIV risk, and a lack of expertise and resources to conduct time-intensive risk assessments and counseling related to PrEP.ConclusionBelgian family physicians demonstrated a keen willingness to be involved in PrEP care, but had differing views on the practical implementation into their practices. Providing tailored training on sexual health and PrEP, and investing in collaboration between primary and secondary care, could optimize the integration of PrEP in the primary care practice.

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An Experimental Study of the Effects of Patient Race, Sexual Orientation, and Injection Drug Use on Providers’ PrEP-Related Clinical Judgments

et al. 2021

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Evaluating family physicians’ willingness to prescribe PrEP

Cited by 4 publications

References 19 publications

Prescribing pre-exposure prophylaxis (PrEP) for HIV prevention: A cross-sectional survey of General Practitioners in Australia

Prescribing pre-exposure prophylaxis (PrEP) for HIV prevention: A cross-sectional survey of General Practitioners in Australia

How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium

An Experimental Study of the Effects of Patient Race, Sexual Orientation, and Injection Drug Use on Providers’ PrEP-Related Clinical Judgments

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