Primary Care Provider HIV PrEP Knowledge, Attitudes, and Prescribing Habits: A Cross-Sectional Survey of Late Adopters in Rural and Suburban Practice

• Published in: Journal of primary care & community health Vol. 14; p. 21501319221147254
• Main Authors: Sell, Jarrett, Chen, Rensa, Huber, Christopher, Parascando, Jessica, Nunez, Jonathan
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2023; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Anti-HIV Agents - therapeutic use; Attitudes; Clinical experience; Cross-Sectional Studies; Epidemics; Family physicians; Habits; Health Knowledge, Attitudes, Practice; HIV; HIV Infections - drug therapy; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Medical personnel; Pilot Study; Polls & surveys; Practice Patterns, Physicians; Prescribing; Prevention programs; Preventive medicine; Primary care; Primary Health Care; Respondents; Surveys and Questionnaires; prep; primary care; suburban; HIV; rural
• ISSN: 2150-1319; 2150-1327
• DOI: 10.1177/21501319221147254

Objective: Pre-exposure prophylaxis (PrEP) is a recommended strategy for HIV prevention, yet PrEP prescribing rates in primary care remain low. The aim of this study was to further describe the current knowledge, attitudes, and prescribing behaviors of HIV PrEP in primary care providers with a focus on the perceived barriers and facilitators to PrEP prescribing. Methods: Cross-sectional survey of primary care providers at rural and suburban practices in a large academic institution. Results: Survey response rate was 48.0% (n = 134). Most respondents (96.3%) reported little clinical experience in care of persons living with HIV. Respondents self-reported positive attitudes and high overall knowledge of PrEP with low prescribing rates and less comfort with lab testing. More respondents are asked about PrEP by patients (54%) than start conversations about PrEP with patients (39%). Family Physicians and providers 5 to 10 years from completion of training overall reported higher knowledge, attitudes and prescribing behaviors. Lack of PrEP education was identified as the greatest barrier and an electronic medical record order set as the greatest facilitator to prescribing PrEP. Conclusions: With the goal to end the HIV epidemic, PrEP provision in nonurban primary care settings may be an important strategy for increased access to PrEP and reduced HIV transmission. This study, which includes a variety of providers that possess high knowledge, yet low experience prescribing PrEP, likely demonstrates the limitations of interventions which solely focus on provider education. System-based practice solutions, such as order sets, may be needed to target infrequent prescribers of PrEP.