Exploratory survey of Florida pharmacists’ experience, knowledge, and perception of HIV pre-exposure prophylaxis

Shaeer, Kristy M.; Sherman, Elizabeth M; Shafiq, S; Hardigan, Patrick C.

doi:10.1331/japha.2014.14014

Cited by 40 publications

(37 citation statements)

References 22 publications

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“…The final set of articles (n = 47) included four broad categories of papers: primary data on cognitive variables (e.g., perspectives, beliefs, and concerns) of HIV-prevention providers (n = 18) [ 9 , 14 , 30 – 45 ]; primary data on cognitive variables and perspectives of individuals considered at risk for HIV infection (n = 9) [ 46 – 54 ]; reviews of current literature on PrEP implementation (n = 16) [ 10 , 11 , 17 , 19 , 55 – 66 ]; and case studies of PrEP demonstration and implementation projects (n = 4) [ 12 , 54 , 67 , 68 ]. From the text of these articles, we extracted and recorded key barriers to implementation and the interventions proposed to address them.…”

Section: Resultsmentioning

confidence: 99%

Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

et al. 2018

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There are many challenges to accessing PrEP and thus low uptake in the United States. This review (2007–2017) of PrEP implementation identified barriers to PrEP and interventions to match those barriers. The final set of articles (n = 47) included content on cognitive aspects of HIV service providers and individuals at risk for infection, reviews, and case studies. Cognitive barriers and interventions regarding patients and providers included knowledge, attitudes, and beliefs about PrEP. The “purview paradox” was identified as a key barrier—HIV specialists often do not see HIV-negative patients, while primary care physicians, who often see uninfected patients, are not trained to provide PrEP. Healthcare systems barriers included lack of communication about, funding for, and access to PrEP. The intersection between PrEP-stigma, HIV-stigma, transphobia, homophobia, and disparities across gender, racial, and ethnic groups were identified; but few interventions addressed these barriers. We recommend multilevel interventions targeting barriers at multiple socioecological domains.

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Section: Resultsmentioning

confidence: 99%

Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

et al. 2018

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“…Despite this increase, providers across the globe remain reluctant to provide PrEP. Between 9% [35, 36] and 19% [87] of clinicians had prescribed PrEP and 22% of pharmacists [78] had dispensed it. Two studies showed that the likelihood of prescribing PrEP increased when providers cared for more HIV-positive patients, [35] had higher PrEP knowledge, were older, and believed PrEP would empower women.…”

Section: Resultsmentioning

confidence: 99%

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

et al. 2016

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Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990–April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

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“…Counseling on the benefits of PrEP, and providing information and reassurance on the risk and monitoring of short-and long-term side effects, may also improve adherence to PrEP [119]. It is also imperative that educational interventions are targeted to primary care providers, including training to increase PrEP knowledge [120] and to alleviate concerns regarding PrEP safety [98]. Concerns around risk compensation (or an increase in risk-taking behaviors among individuals at risk prompted by a decrease in perceived HIV risk) appear to be one factor that can cause reluctance among some healthcare providers to prescribe PrEP to eligible patients [53].…”

Section: Potential Solutions To Barriersmentioning

confidence: 99%

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

2020

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Antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV transmission was first approved by the US Food and Drug Administration in 2012. Despite correlations of decreases in new HIV infections being greatest where PrEP has been deployed, the uptake of PrEP is lagging, particularly among populations with disproportionate HIV burden. This narrative review seeks to identify individual and systemic barriers to PrEP usage in the USA. A comprehensive search of recent literature uncovered a complex array of structural, social, clinical, and behavioral barriers, including knowledge/awareness of PrEP, perception of HIV risk, stigma from healthcare providers or family/partners/friends, distrust of healthcare providers/systems, access to PrEP, costs of PrEP, and concerns around PrEP side effects/medication interactions. Importantly, these barriers may have different effects on specific populations at risk. The full potential of PrEP for HIV prevention will not be realized until these issues are addressed. Strategies to achieve this goal should include educational interventions, innovative approaches to delivery of HIV care, financial support, and destigmatization of PrEP and PrEP users. Until then, PrEP uptake will continue to be suboptimal, particularly among those who need it most.

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Exploratory survey of Florida pharmacists’ experience, knowledge, and perception of HIV pre-exposure prophylaxis

Cited by 40 publications

References 22 publications

Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

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