HIV pre‐exposure prophylaxis awareness, practices, and comfort among urban and rural family medicine physicians

Abstract

Purpose: HIV rates are increasing in rural areas, and adolescents are disproportionately affected. HIV pre-exposure prophylaxis (PrEP) is a daily pill that is effective at preventing HIV; however, PrEP uptake among adolescents is low. PrEP is dependent on primary care providers (PCPs) prescribing it, but research has overwhelmingly sampled urban PCPs. This study compared the PrEP awareness, practices, and comfort between rural and urban family medicine physicians. Methods: A total of 256 family medicine physicians in the United States were recruited from a Qualtrics panel to complete an online cross-sectional survey between July 15 and August 9, 2022. Participants completed items assessing their demographic characteristics and PrEP awareness, practices, and comfort. A chi-square test of independence and multiple logistic regression were used to determine rural/urban differences. Findings: Rural family medicine physicians were less comfortable than urban family medicine physicians in providing sexual risk reduction counseling to adolescents, telling an adolescent patient their HIV test result was HIV positive, and implementing all of the PrEP clinical activities for adolescents. Conclusions: Education, skill-building, and collaborative partnership interventions could improve the comfort levels of rural family medicine physicians in implementing the PrEP guidelines for their adolescent patients. Future research is needed to understand the factors that explain the differences in PrEP-related attitudes and practices between urban and rural family medicine physicians. Results from such studies could inform provider-based interventions that ultimately increase PrEP use and decrease HIV rates among rural adolescents.

A Multicomponent Intervention to Train and Support Family Medicine Providers to Promote Pre-exposure Prophylaxis (PrEP) for Adolescent Girls and Young Women in the Deep South: Protocol for the PrEP-Pro Study

“…To our knowledge, this is the first provider intervention that seeks to promote PrEP prescription among adolescent girls and young women in the South. Working with FM trainees is an innovative approach to promoting PrEP provision among clinicians who work with adolescents in rural communities across the United States [ 35 , 81 ]. Adapting PrEP-Pro to trainees provides an opportunity to modify clinician behavior at an early stage of training and help seed the rural health workforce with effective HIV prevention advocates and providers.…”

Development, Pre-Testing and Feasibility Testing of Multi-Component Interventions, Critical for Mental Health Promotion in Primary Care among Mexican-American Adolescents Living in Rural America

“…HIV is increasing in rural, minority and adolescent populations [ 8 ]. Relationships between substance use and behaviors that result in unintended pregnancy, violence and sexually transmitted infection (STI) among adolescent women have been described [ 9 , 10 ].…”