HIV-Related Training and Correlates of Knowledge, HIV Screening and Prescribing of nPEP and PrEP Among Primary Care Providers in Southeast United States, 2017

Abstract

The Southeast accounted for most HIV diagnoses (52%) in the United States in 2015. Primary care providers (PCPs) play a vital role in HIV prevention for at-risk persons and treatment of persons living with HIV. We studied HIV-related training, knowledge, and clinical practices among PCPs in the Southeast to address knowledge gaps to inform HIV prevention strategies. Between April and August 2017, we conducted an on-line survey of a representative sample of PCPs in six Southeast jurisdictions with high rates of HIV diagnoses (Atlanta; Baltimore; Baton Rouge; District of Columbia; Miami; New Orleans). We defined HIV-related training as self-reported completion of any certified HIV/STD course or continuing education in past 24 months (prior to survey completion). We assessed associations between training and HIV testing practices, familiarity with nonoccupational post-exposure prophylaxis (nPEP) and pre-exposure prophylaxis (PrEP), and ever prescribing nPEP or PrEP. There were 820 participants after fielding 4595 surveys (29.6% adjusted response rate). In weighted analyses, 36.3% reported HIV-related training. Using adjusted prevalence ratio (aPR) and confidence intervals (CI), we found that PCPs with HIV-related training (compared to those with no training) were more likely to be familiar with nPEP (aPR = 1.32, 95% CI 1.05, 1.67) and PrEP (aPR = 1.67, 95% CI 1.19, 2.38); and to have ever prescribed PrEP to patients (aPR = 1.75, 95% CI 1.10, 2.78). Increased HIV-related trainings among PCPs in high HIV prevalence Southeast jurisdictions may be warranted. Strengthening nPEP and PrEP familiarity among PCPs in Southeast may advance national HIV prevention goals.

Quality of care for Black and Latina women living with HIV in the U.S.: a qualitative study

“…Recent studies have identified gaps in provider knowledge of HIV-related services, and in the actual provision of those HIV-related services to women [36,37]. Thus, provider knowledge has been a focal point of HIV prevention and treatment interventions, with demonstrated success in improving outcomes along the HIV prevention and treatment care continuum [37,38]. Beyond HIV-specific medical education, training and development in structural competency may be particularly salient for medical professionals who serve Black and Latina WLWH because such trainings show promise in preparing providers to address aspects of the distinct and overlapping social and institutional barriers to health experienced by WLWH [39,40].…”

Prior HIV testing behaviour is associated with HIV testing results among men, trans women and trans men who have sex with men in the United States

“…This highlights the important function that simply having a primary care provider has in access to basic healthcare like HIV testing. 11 12 Meanwhile, those with HIV-positive results, regardless of how recent their previous HIV test was prior to enrollment, differed from those with negative results in many ways that are known to be associated with HIV risk. These included racial and income disparities, housing instability, recent transactional sex, and perhaps most notably, recent methamphetamine use.…”

Context and Barriers to the Prescription of Nonoccupational Postexposure Prophylaxis Among HIV Medical Care Providers: National Internet-Based Observational Study in China

“…HIV medical care providers play an indispensable role in nPEP uptake, especially medication prescription [17]. Previous surveys have reported on HIV care providers prescribing nPEP in developed countries [18][19][20][21][22][23], most often including factors such as practice specialty, the number of persons living with HIV in treatment, provider familiarity with nPEP, and the nPEP guideline in place [18,19,23]. As these surveys were conducted in developed countries with nPEP guidelines, it is uncertain whether the situation is similar in developing countries without nPEP guidelines.…”