Intentions to Prescribe Preexposure Prophylaxis Are Associated With Self-efficacy and Normative Beliefs

Sachdev, Darpun; Stojanovski, Kristefer; Liu, Albert Y.; Buchbinder, Susan; Macalino, Grace

doi:10.1093/cid/ciu229

Cited by 18 publications

(20 citation statements)

References 3 publications

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“…Similar to findings in other studies, [22][23][24][25][26][27] we found variability in clinician reports of PrEP target populations. Clinicians were explicit in reporting which patients would be eligible for PrEP, including patients who are members of specific populations who are at high risk of HIV infection, as well as those able to access and adhere to PrEP and PrEP monitoring.…”

Section: Discussionsupporting

confidence: 88%

Clinician Attitudes Toward CDC Interim Pre-Exposure Prophylaxis (PrEP) Guidance and Operationalizing PrEP for Adolescents

Mullins

Lally

Zimet

et al. 2015

AIDS Patient Care and STDs

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Prior to issuing formal HIV pre-exposure prophylaxis (PrEP) clinical practice guidelines in 2014, the US Centers for Disease Control and Prevention (CDC) had released interim guidance for oral PrEP use among adults. Because oral PrEP may be used off-label for youth and may soon be indicated for minor adolescents, we examined the potential adoption of the interim guidance among clinicians who care for HIV-infected and at-risk youth. Individual, semi-structured interviews were conducted with 15 US clinicians who were recruited through an adolescent HIV research network. The theory-driven interview guide, consisting primarily of openended questions, assessed demographics, familiarity with the guidance, attitudes toward the guidance, and attitudes toward the use of the guidance for adult and adolescent patients. Transcripts were analyzed using framework analysis. Most clinicians (11/15) reported that the guidance was compatible with their practice, although several reported that some aspects, particularly frequency of follow-up visits, needed to be tailored to meet their patients' needs. We found variability in clinician reported characteristics of appropriate PrEP candidates (e.g., youth with substance use and mental health issues were noted to be both suitable and unsuitable PrEP candidates) and PrEP use in serodiscordant couples (e.g., whether PrEP would be recommended to a patient whose HIV-infected partner is virally suppressed). Clinician reported steps for initiation, monitoring, and discontinuing PrEP were largely consistent with the guidance. The observed variability in clinician practice with regard to oral PrEP may be reduced through interventions to educate clinicians about the content and rationale for guideline recommendations.

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Section: Discussionsupporting

confidence: 88%

Clinician Attitudes Toward CDC Interim Pre-Exposure Prophylaxis (PrEP) Guidance and Operationalizing PrEP for Adolescents

Mullins

Lally

Zimet

et al. 2015

AIDS Patient Care and STDs

View full text Add to dashboard Cite

show abstract

“…Lack of access to a healthcare provider and insurance or funds to pay for the medication, in addition to discomfort discussing PrEP use with a provider, have been identified as barriers among potential MSM users (11–13, 16). In addition, barriers to PrEP endorsement by providers remain, potentially driven by a lack of knowledge about the drug and concerns about its safety (17, 18) despite the CDC’s release of the PrEP Clinical Practice Guideline in 2014 (19). For example, a study of HIV and non-HIV internists and family practice providers revealed concerns about PrEP, including drug toxicity, adherence, and development of resistance (17).…”

Section: Introductionmentioning

confidence: 99%

Exploring Patterns of Awareness and Use of HIV Pre-Exposure Prophylaxis Among Young Men Who Have Sex with Men

et al. 2016

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Pre-exposure prophylaxis (PrEP) has shown promise as a safe and effective HIV prevention strategy, but there is limited research on awareness and use among young men who have sex with men (YMSM). Using baseline data from the “Keep It Up! 2.0” randomized control trial, we examined differences in PrEP awareness and use among racially diverse YMSM (N = 759; mean age = 24.2 years). Participants were recruited from study sites in Atlanta, Chicago, and New York City, as well as through national advertising on social media applications. While 67.5% of participants reported awareness of PrEP, 8.7% indicated using the medication. Awareness, but not use, varied by demographic variables. PrEP-users had twice as many condomless anal sex partners (ERR = 2.05) and more condomless anal sex acts (ERR = 1.60) than non-users. Future research should aim to improve PrEP awareness and uptake among YMSM and address condom use.

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“…Although PCPs encounter patients who may benefit from PrEP, they may not be aware of PrEP or comfortable prescribing it. Only a minority of PCPs (28%–45%) currently indicate a willingness to prescribe PrEP, 11 and fewer still (0%–17%) have prescribed it. 12–15 Notably, relatively few studies have evaluated the PrEP experiences of non-HIV providers.…”

Section: Introductionmentioning

confidence: 99%

“…12–15 Notably, relatively few studies have evaluated the PrEP experiences of non-HIV providers. 11,12,15–18 …”

Section: Introductionmentioning

confidence: 99%

“…27 Regarding PrEP specifically, PrEP knowledge is associated with willingness to prescribe PrEP 28 as well as future intention to prescribe and experience prescribing PrEP among HIV and non-HIV providers, 15 and PrEP prescription self-efficacy is associated with intentions to prescribe PrEP. 11 No studies have tested the IMB model in predicting PrEP behaviors among health providers.…”

Section: Introductionmentioning

confidence: 99%

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Factors Related to Pre-exposure Prophylaxis Prescription by U.S. Primary Care Physicians

Walsh

Petroll

2017

American Journal of Preventive Medicine

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Introduction Although pre-exposure prophylaxis (PrEP) greatly reduces risk of HIV infection in HIV-negative individuals, use is not widespread enough to impact HIV incidence. Involvement of primary care physicians (PCPs) in PrEP prescription is essential, but previous research has shown low rates of prescription among PCPs. To identify targets for interventions, the information–motivation–behavioral skills model for PrEP discussion and prescription was tested in a ten-city sample of PCPs. Methods PCPs from ZIP codes with high HIV incidence in ten U.S. cities (N=280, 52% male, 56% white) completed a survey online between July 2014 and May 2015. Information items assessed knowledge, motivation items evaluated attitudes, and behavioral skills items measured comfort with behaviors involved in prescribing PrEP. Providers indicated whether they had discussed PrEP with or prescribed PrEP to patients. Data were analyzed in 2015 and 2016. Results One third of PCPs had discussed and 17% had prescribed PrEP. A structural equation model with good fit supported the information–motivation–behavioral skills model. Information and motivation predicted behavioral skills (b=0.35, 95% CI=0.13, 0.57 and b=0.31, 95% CI=0.14, 0.47, respectively). Behavioral skills predicted prescription (OR=1.31, 95% CI=1.13, 1.53). Behavioral skills mediated effects of information and motivation on prescription (OR=1.10, 95% CI=1.03, 1.21 and OR=1.09, 95% CI=1.03, 1.17, respectively). Conclusions The information–motivation–behavioral skills model can be applied to PCPs’ PrEP discussion and prescription. Its constructs represent potential targets for PCP-directed interventions to increase PrEP use in high-risk populations.

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Intentions to Prescribe Preexposure Prophylaxis Are Associated With Self-efficacy and Normative Beliefs

Cited by 18 publications

References 3 publications

Clinician Attitudes Toward CDC Interim Pre-Exposure Prophylaxis (PrEP) Guidance and Operationalizing PrEP for Adolescents

Clinician Attitudes Toward CDC Interim Pre-Exposure Prophylaxis (PrEP) Guidance and Operationalizing PrEP for Adolescents

Exploring Patterns of Awareness and Use of HIV Pre-Exposure Prophylaxis Among Young Men Who Have Sex with Men

Factors Related to Pre-exposure Prophylaxis Prescription by U.S. Primary Care Physicians

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