Student Education About Pre-exposure Prophylaxis (PrEP) Varies Between Regions of the United States

Abstract

BACKGROUND: Daily, oral pre-exposure prophylaxis (PrEP) is an effective and safe prevention strategy for people at risk for HIV. However, prescription of PrEP has been limited for patients at the highest risk. Disparities in PrEP prescription are pronounced among racial and gender minority patients. A significant body of literature indicates that practicing healthcare providers have little awareness and knowledge of PrEP. Very little work has investigated the education about PrEP among health professionals in training. OBJECTIVE: The objective of this study was to compare health professions students' awareness of PrEP and education about PrEP between regions of the US, and to determine if correlations between regional HIV incidence and PrEP use were present. DESIGN: Survey study. PARTICIPANTS: A cross-sectional sample of health professions students (N = 1859) representing future prescribers (MD, DO, PA), pharmacists, and nurses in the US. KEY RESULTS: Overall, 83.4% of students were aware of PrEP, but only 62.2% of fourth-year students indicated they had been taught about PrEP at any time during their training. Education about PrEP was most comprehensive in the Northeastern US, the area with the highest PrEP to need ratio (4.7). In all regions, transgender patients and heterosexual men and women were least likely to be presented in education as PrEP candidates, and men who have sex with men were the most frequently presented. CONCLUSIONS: There are marked differences in education regarding PrEP both between academic programs and regions of the USA.

Pharmacy-Based Interventions to Increase Use of HIV Pre-exposure Prophylaxis in the United States: A Scoping Review

“…2 ). This could suggest incongruence between where PrEP is most needed and where pharmacists are likely to be familiar with PrEP [ 57 ]. This finding could also suggest that pharmacists in areas with high HIV rates are already familiar with PrEP, indicating a more critical need for evaluation of pharmacist knowledge of PrEP in other U.S. regions.…”

“…For future pharmacists currently receiving PharmD curriculum, studies showed increasing integration of PrEP education into PharmD programs, providing data from all four regions of the U.S. [ 57 ]. No qualitative or longitudinal studies measured pharmacy student knowledge of or attitudes toward PrEP.…”

Race and Sexual Identity Differences in PrEP Continuum Outcomes Among Latino Men in a Large Chicago Area Healthcare Network

“…There is a dearth of research on PrEP in heterosexual men in the context of the United States. Heterosexual men are among the least likely populations to be presented to healthcare providers as potential PrEP candidates in PrEP-related training curriculum across all regions of the U.S. [50]. This trend may impact the degree to which healthcare providers perceive heterosexual men as candidates for PrEP despite there being PrEP eligibility criteria that are relevant to heterosexual men (e.g.…”

Knowledge of HIV and HIV pre-exposure prophylaxis among medical and pharmacy students: A national, multi-site, cross-sectional study

“…This over-representation is due to a majority of the schools that participated in this study being located in the Midwestern U.S. For this reason, we included region as a covariate. A future study may benefit from targeted investigation of PrEP/HIV knowledge in the Southern U.S. given the region’s high HIV burden and previous work showing sub-optimal health professions education about PrEP in the Southern U.S ( Bunting et al, 2020 ). We were unable to compare the demographics of our sample to the demographic composition of the students who did not respond as we did not have access to the demographic details of the student bodies at all participating institutions.…”

“…Ensuring current disparities in HIV incidence and PrEP prescription are not propagated requires educating health professionals in training about HIV-prevention in the biomedical era. Previous work evaluating health professions curriculum has found that medical and pharmacy students receive inadequate training about PrEP effectiveness, patient indications, and PrEP and HIV disparities, and that over 30% of fourth-year medical and pharmacy students did not receive training about PrEP ( Bunting et al, 2020 ). A national study of medical and pharmacy students conducted in 2019 found that students were unsure of the connection between PrEP and widespread HIV-resistance, and which patient populations are indicated for PrEP ( Bunting et al, 2020 ).…”