Knowledge, Attitudes, and PrEP Prescribing Practices of Health Care Providers in Philadelphia, PA

Abstract

Introduction: Preexposure prophylaxis (PrEP) is an effective biomedical intervention that has the potential to dramatically decrease the incidence of HIV but remains an underutilized method of HIV prevention. The Philadelphia Department of Public Health administered an online survey to health care providers in the Philadelphia area with the aim of characterizing PrEP attitudes, knowledge, and prescribing practices. Methods: Online surveys were distributed to 1000 providers who were recruited through distribution lists of Philadelphia medical providers between September and December 2017. A Likert-type response scale was utilized to analyze participant self-reported responses. Participant practice settings included HIV/ID, family and internal medicine, women’s health, and pediatric/adolescent clinics. Results and Discussion: The response rate of the survey was 9%. Of 81 complete responses, 75% (N = 61) felt comfortable providing PrEP and 77% (N = 62) had ever written a PrEP prescription. Compared with primary care providers, HIV care providers were significantly more knowledgeable about required laboratory testing for prescribing PrEP ( P = .03) and were more likely to have prescribed PrEP to more than 10 patients ( P = .006). Women’s health and pediatric providers reported feeling less comfortable providing PrEP to their patients ( P = .0003). Conclusion: The majority of health care providers in the Philadelphia area who responded to the survey reported experience with providing PrEP to their patients. In the present study, HIV care providers were significantly more comfortable and knowledgeable about prescribing PrEP compared with providers in primary care, women’s health, and/or adolescent/pediatric medicine. Results were limited by sampling bias, as providers who responded to the survey may have prior experience with PrEP. Future Health Department educational trainings need to target primary and preventive care providers, providers who have never prescribed PrEP, and providers who see few patients living with HIV.

Tennessee Healthcare Provider Practices, Attitudes, and Knowledge Around HIV Pre-Exposure Prophylaxis

“…Though less than half (43%) of survey respondents had prescribed PrEP in the previous 12 months, this proportion is greater than previously reported in the literature (4%-39%), 26 , 27 , 32 - 35 excluding one convenience sample of Philadelphia HIV/ID and non-HIV providers with an unusually high rate of PrEP prescription (77%). 36 Our finding may reflect the trend of increasing PrEP provision over time. 14 Provider surveys that included both PCPs and HIV/ID specialists have consistently reported that PCPs prescribed PrEP less often than HIV/ID specialists; 26 , 27 , 32 , 36 given that our results were primarily gathered from PCPs with very few responses from ID specialists (n = 3), this increased proportion of PrEP prescribers may be reflective of TN PCPs in general.…”

“… 36 Our finding may reflect the trend of increasing PrEP provision over time. 14 Provider surveys that included both PCPs and HIV/ID specialists have consistently reported that PCPs prescribed PrEP less often than HIV/ID specialists; 26 , 27 , 32 , 36 given that our results were primarily gathered from PCPs with very few responses from ID specialists (n = 3), this increased proportion of PrEP prescribers may be reflective of TN PCPs in general.…”

Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists

“…The skipping rate for each question was satisfactory, ranging from 0% to 38.6% and the mean time to completion was almost 13 minutes. Because we gave no incentives to participants and we used a long questionnaire (39 questions), we consider our participation rate of 18.2% as very good, and in line with recent online surveys evaluating practice patterns by healthcare providers in which participation rates varied from 2% to 25% (18)(19)(20)(21)(22).…”

Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists

“…Because we gave no incentives to participants and we used a long questionnaire (39 questions), we consider our participation rate of 18.2% as very good, and in line with recent online surveys evaluating practice patterns by healthcare providers in which participation rates varied from 2% to 25%. (18–22)…”

“…Because we gave no incentives to participants and we used a long questionnaire (39 questions), we consider our participation rate of 18.2% as very good, and in line with recent online surveys evaluating practice patterns by healthcare providers in which participation rates varied from 2% to 25%. (18)(19)(20)(21)(22) The outbreak of COVID-19 has drastically changed how outpatient care is delivered in health care practices. To decrease the risk of contamination for patients and health care workers, providers are deferring elective and preventive visits as well as non-emergency surgeries.…”