Learning by Doing: Lessons From the Care and Prevention in the United States Demonstration Project

Williams, Kim; Taylor, Raekiela D.; Painter, Thomas M.; Jeffries, William L.; Prather, Cynthia; Spikes, Pilgrim; Mulatu, Mesfin S.; Henny, Kirk D.; Hoyte, Tamika; Flores, Stephen A.

doi:10.1177/0033354918803611

Cited by 7 publications

(1 citation statement)

References 23 publications

(33 reference statements)

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“…The National HIV/AIDS Strategy (The White House Office of National AIDS Policy, 2015) and federally-funded demonstration projects (Centers for Disease Control and Prevention, 2016a,b, 2017) promote coordinated HIV care via organizational collaborations across federal, state, and local public health entities to work with clinical care and other service support providers. However, reports have documented the challenges associated with implementing such models (Williams et al, 2018; Kimmel et al, 2016). Our findings suggest PCPs could benefit from more education about use of ARVs for prevention such as through collaborations with local health organizations and thereby improve coordinated care, particularly within jurisdictions located in the Southeast.…”

Section: Discussionmentioning

confidence: 99%

HIV prescriptions on the frontlines: Primary care providers' use of antiretrovirals for prevention in the Southeast United States, 2017

Henny

Duke

Brooks

et al. 2020

Preventive Medicine

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HIV disproportionately affects persons in Southeast United States. Primary care providers (PCPs) are vital for HIV prevention. Data are limited about their prescribing of antiretrovirals (ARVs) for prevention, including nonoccupational post-exposure prophylaxis (nPEP), pre-exposure prophylaxis (PrEP), and antiretroviral therapy (ART). We examined these practices to assess gaps. During April–August 2017, we conducted an online survey of PCPs in Atlanta, Baltimore, Baton Rouge, Miami, New Orleans, and Washington, DC to assess HIV-related knowledge, attitudes and practices. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were used to estimate correlates of nPEP, PrEP and ART prescribing practices. Adjusting for MSA and specialty, the weighted sample (n =820, 29.6% adjusted response rate) comprised 60.2% white and 59.4% females. PCPs reported ever prescribing nPEP (31.0%), PrEP (18.1%), and ART (27.2%). Prescribing nPEP was associated with nPEP familiarity (aPR =2.63, 95% CI 1.59, 4.35) and prescribing PrEP (aPR= 3.57, 95% CI 2.78, 4.55). Prescribing PrEP was associated with PrEP familiarity (aPR =4.35, 95% CI 2.63, 7.14), prescribing nPEP (aPR =5.00, 95% CI 2.00, 12.50), and providing care for persons with HIV (aPR=1.56, 95% CI 1.06, 2.27). Prescribing ART was associated with nPEP familiarity (aPR= 1.89, 95% CI 1.27, 2.78) and practicing in outpatient public practice versus hospital-based facilities (aPR= 2.14 95% CI 1.51, 3.04), and inversely associated with collaborations involving specialists (aPR= 0.60, 95% CI 0.42, 0.86). A minority of PCPs surveyed from the Southeast report ever prescribing ARVs for prevention. Future efforts should include enhancing HIV care coordination and developing strategies to increase use of biomedical tools.

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Section: Discussionmentioning

confidence: 99%