United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey

Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J.

doi:10.1016/j.contraception.2015.12.018

Cited by 119 publications

(87 citation statements)

References 14 publications

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“…Because PrEP is a biomedical intervention that requires a prescription, it might reasonably be presumed that many women would learn about PrEP from their healthcare professionals. However, the limited awareness of PrEP that exists among women and their healthcare providers,69 despite the availability of PrEP as a US Food and Drug Administration-approved medication for ~5 years,70 suggests that additional efforts to disseminate information about PrEP outside of care settings are needed. Social marketing campaigns and other approaches that leverage community-led communication networks, such as social media networks created by and for women, could provide a means to spread accurate information about PrEP in a manner that is accessible, trustworthy, and empowering for women.…”

Section: Raising Awareness Of Prepmentioning

confidence: 99%

Pre-exposure prophylaxis for HIV prevention in women: current perspectives

Flash¹,

Dale²,

Krakower³

2017

IJWH

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There are ~900,000 new HIV infections among women every year, representing nearly half of all new HIV infections globally. In the US, nearly one-fifth of all new HIV infections occur among women, and women from racial and ethnic minority communities experience disproportionately high rates of new HIV infections. Thus, there is a need to develop and implement effective HIV prevention strategies for women in the US and internationally, with a specific need to advance strategies in minority communities. Previous studies have demonstrated that oral HIV pre-exposure prophylaxis (PrEP), the use of antiretroviral medications by HIV-uninfected persons to prevent HIV acquisition, can reduce HIV incidence among women who are adherent to PrEP. However, to date, awareness and uptake of PrEP among women have been very limited, suggesting a need for innovative strategies to increase the knowledge of and access to PrEP among women in diverse settings. This narrative review summarizes the efficacy and safety data of PrEP in women, discusses considerations related to medication adherence for women who use PrEP, and highlights behavioral, social, and structural barriers to maximize the effectiveness of PrEP in women. It also reviews novel modalities for PrEP in women which are being developed and tested, including topical formulations and long-acting injectable agents that may offer advantages as compared to oral PrEP and proposes a community-oriented, social networking framework to increase awareness of PrEP among women. If women are provided with access to PrEP and support to overcome social and structural barriers to adhere to PrEP, this prevention strategy holds great promise to impact the HIV epidemic among women in the US and globally.

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Section: Raising Awareness Of Prepmentioning

confidence: 99%

Pre-exposure prophylaxis for HIV prevention in women: current perspectives

Flash¹,

Dale²,

Krakower³

2017

IJWH

View full text Add to dashboard Cite

show abstract

“…A recent U.S. survey study of family planning providers, who may be expected to provide care to youth, found they had limited knowledge of PrEP; although three quarters of respondents thought HIV education was an essential part of a family planning visit, only a quarter thought PrEP education was essential as a part of HIV prevention counseling [33]. When asked to consider PrEP specifically for adolescent minors, U.S. providers described additional concerns including lack of clarity about confidentiality laws and ability to consent patients without parental involvement [31].…”

Section: Other Considerations Regarding Prep For Youthmentioning

confidence: 99%

HIV preexposure prophylaxis for adolescents and young adults

Allen

Gordon

Krakower

et al. 2017

Current Opinion in Pediatrics

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STRUCTURED ABSTRACT Purpose of review This review describes the evidence for HIV pre-exposure prophylaxis (PrEP) with daily combined tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) in adolescents and young adults. Current recommendations are described, as are the unique medical, socioeconomic, and legal considerations regarding the use of PrEP for youth. Recent findings PrEP with daily oral TDF-FTC has been shown to help prevent new HIV infection among adults at substantial risk. Evidence suggests a protective benefit of PrEP for youth at risk for HIV, although low adherence is emerging as a barrier to effective use. Summary Effective use of antiretrovirals for PrEP represents a seminal development in HIV prevention efforts. Improving access and adherence to PrEP for youth has the potential to substantially reduce the incidence of HIV in this population.

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“…The PCP PrEP Survey was informed by a literature review of health care providers' PrEPrelated knowledge, attitudes, and behaviors, [11][12][13][14][15][16][21][22][23][25][26][27][28][29][30][31][32] an existing survey instrument, 33 and feedback from community members involved in HIV prevention research. It was developed and pilot-tested in an iterative fashion by the authors, most of whom are PCPs who provide HIV care and/or researchers who conduct HIV bio-behavioral research (Online Appendix).…”

Section: Data Collectionmentioning

confidence: 99%

A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians

et al. 2016

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BACKGROUND: Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. OBJECTIVE: To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. DESIGN: Cross-sectional online survey conducted in April and May 2015. RESPONDENTS: Members of a national professional organization for academic primary care physicians (n = 266). MAIN MEASURES: PrEP awareness, PrEP adoption (ever prescribed or referred a patient for PrEP [yes/no]), provider and practice characteristics, and self-rated knowledge, attitudes, and beliefs associated with adoption. KEY RESULTS: The survey response rate was 8.6 % (266/2093). Ninety-three percent of respondents reported prior awareness of PrEP. Of these, 34.9 % reported PrEP adoption. In multivariable analysis of provider and practice characteristics, compared with non-adopters, adopters were more likely to provide care to more than 50 HIV-positive patients (vs. 0, aOR = 6.82, 95 % CI 2.06-22.52). Compared with non-adopters, adopters were also more likely to report excellent, very good, or good selfrated PrEP knowledge (15.1 %, 33.7 %, 30.2 % vs. 2.5 %, 18.1 %, 23.8 %, respectively; p < 0.001) and to perceive PrEP as extremely safe (35.1 % vs. 10.7 %; p = 0.002). Compared with non-adopters, adopters were less likely to perceive PrEP as being moderately likely to increase risk behaviors ("risk compensation") (12.8 % vs. 28.8 %, p = 0.02). CONCLUSIONS: While most respondents were aware of PrEP, only one-third of PrEP-aware PCPs reported adoption. Adopters were more likely to have experience providing HIV care and to perceive PrEP as extremely safe, and were less likely to perceive PrEP use as leading to risk compensation. To enhance PCP adoption of PrEP, educational efforts targeting PCPs without HIV care experience should be considered, as well as training those with HIV care experience to be PrEP "clinical champions". Concerns about safety and risk compensation must also be addressed.

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United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey

Cited by 119 publications

References 14 publications

Pre-exposure prophylaxis for HIV prevention in women: current perspectives

Pre-exposure prophylaxis for HIV prevention in women: current perspectives

HIV preexposure prophylaxis for adolescents and young adults

A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians

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