Basic Knowledge Among GP Trainees Regarding HIV Pre- and Post-exposition-prophylaxis

Overview

Journal J Family Med Prim Care

Specialty Public Health

Date 2021 Nov 11

PMID 34760745

Authors

Christian Flossner

Meri Avetisyan

Thomas Frese

Affiliations

Soon will be listed here.

Abstract

Introduction: Preventing human immunodeficiency virus (HIV) infection is central to containing the HIV pandemic. For pre- and post-exposure prophylaxis (PrEP and PEP), drugs approved in Germany are available. Basic information on this should be obtained from physicians in further training to become specialists in General Practice (GP) since they may have to deal with this topic of high relevance for the health of patients at risk and also the physicians' health after a possible exposure in the professional context.

Methodology: A multiple-choice questionnaire was handed out to doctors in further training in General Practice on seminar days of the Competence Centre for General Practice Saxony-Anhalt for an immediate answer.

Results: Of the 109 doctors, 73 completed the questionnaire. A general high relevance of the topic HIV was stated by 95%. In contrast, 71% said it was relevant for family doctor activities. The knowledge questions on the prevalence were answered correctly for all questions with less than 40%; 21% stated that they knew the indication prerequisite for a PEP; 49% answered the question about the period of the highest efficacy of PEP correctly. PrEP as a drug option for prophylaxis is known to a part of the respondents, 79% would prescribe PrEP, 69% were in favour of a health insurance benefit.

Discussion: The results show that the necessary basic knowledge about HIV is partly available. Basic knowledge on structured action in the fields of HIV testing, PEP and PrEP should be taught in a manner appropriate to the relevance of the topic in the context of the German general practice setting. Even a basic knowledge about PEP may help to ensure that the general practice teams receive proper measures after a possible exposition.

References

Aceto L, Karrer U, Grube C, Oberholzer R, Hasse B, Presterl E . [Primary HIV-1 infection in Zurich: 2002-2004]. Praxis (Bern 1994). 2005; 94(32):1199-205. DOI: 10.1024/0369-8394.94.32.1199. View

Mocroft A, Lundgren J, Sabin M, Monforte A, Brockmeyer N, Casabona J . Risk factors and outcomes for late presentation for HIV-positive persons in Europe: results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE). PLoS Med. 2013; 10(9):e1001510. PMC: 3796947. DOI: 10.1371/journal.pmed.1001510. View

. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep. 1992; 41(RR-17):1-19. View

Chou R, Dana T, Grusing S, Bougatsos C . Screening for HIV Infection in Asymptomatic, Nonpregnant Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2019; 321(23):2337-2348. DOI: 10.1001/jama.2019.2592. View

Vogel M, Schwarze-Zander C, Wasmuth J, Spengler U, Sauerbruch T, Rockstroh J . The treatment of patients with HIV. Dtsch Arztebl Int. 2010; 107(28-29):507-15. PMC: 2915483. DOI: 10.3238/arztebl.2010.0507. View

McCormack S, Dunn D, Desai M, Dolling D, Gafos M, Gilson R . Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2015; 387(10013):53-60. PMC: 4700047. DOI: 10.1016/S0140-6736(15)00056-2. View

Szecsenyi J, Niemetz I, Kochen M . [The European study for counseling in HIV antibody testing in general practice: results of the German project section]. Gesundheitswesen. 1993; 55(1 Suppl):46-52. View

Seed C, Styles C, Hoad V, Yang H, Thomas M, Gosbell I . Effect of HIV pre-exposure prophylaxis (PrEP) on detection of early infection and its impact on the appropriate post-PrEP deferral period. Vox Sang. 2020; 116(4):379-387. DOI: 10.1111/vox.13011. View

Carter M, Aaron E, Nassau T, Brady K . Knowledge, Attitudes, and PrEP Prescribing Practices of Health Care Providers in Philadelphia, PA. J Prim Care Community Health. 2019; 10:2150132719878526. PMC: 6777052. DOI: 10.1177/2150132719878526. View

10.

Cornelisse V, Lal L, Price B, Ryan K, Bell C, Owen L . Interest in Switching to On-Demand HIV Pre-Exposure Prophylaxis (PrEP) Among Australian Users of Daily PrEP: An Online Survey. Open Forum Infect Dis. 2019; 6(7):ofz287. PMC: 6612821. DOI: 10.1093/ofid/ofz287. View

11.

Safari N, Rabenau H, Stephan C, Wutzler S, Marzi I, Wicker S . [High-risk needlestick injuries and virus transmission : A prospective observational study]. Unfallchirurg. 2019; 123(1):36-42. DOI: 10.1007/s00113-019-0655-3. View

12.

BERGER E, Doms R, Fenyo E, Korber B, Littman D, Moore J . A new classification for HIV-1. Nature. 1998; 391(6664):240. DOI: 10.1038/34571. View

13.

Hillis A, Germain J, Hope V, McVeigh J, Van Hout M . Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men (MSM): A Scoping Review on PrEP Service Delivery and Programming. AIDS Behav. 2020; 24(11):3056-3070. PMC: 7502438. DOI: 10.1007/s10461-020-02855-9. View

14.

Baggaley R, Dalal S, Johnson C, Macdonald V, Mameletzis I, Rodolph M . Beyond the 90-90-90: refocusing HIV prevention as part of the global HIV response. J Int AIDS Soc. 2016; 19(1):21348. PMC: 5165083. DOI: 10.7448/IAS.19.1.21348. View

15.

Spinner C, Boesecke C, Zink A, Jessen H, Stellbrink H, Rockstroh J . HIV pre-exposure prophylaxis (PrEP): a review of current knowledge of oral systemic HIV PrEP in humans. Infection. 2015; 44(2):151-8. DOI: 10.1007/s15010-015-0850-2. View

16.

Jagel-Guedes E . [The HIV patient in the family physician's practice]. MMW Fortschr Med. 2006; 147 Spec No 1:12-4. View

17.

Schafer G, Kreuels B, Schmiedel S, Hertling S, Hufner A, Degen O . High proportion of HIV late presenters at an academic tertiary care center in northern Germany confirms the results of several cohorts in Germany: time to put better HIV screening efforts on the national agenda?. Infection. 2016; 44(3):347-52. DOI: 10.1007/s15010-016-0880-4. View

18.

Logan L, Fakoya I, Howarth A, Murphy G, Johnson A, Rodger A . Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016. Euro Surveill. 2019; 24(25). PMC: 6593902. DOI: 10.2807/1560-7917.ES.2019.24.25.1800312. View

19.

Spinner C, Boesecke C, Jordan C, Wyen C, Kummerle T, Knecht G . Prevalence of asymptomatic sexually transmitted infections in HIV-positive men who have sex with men in Germany: results of a multicentre cross-sectional study. Infection. 2018; 46(3):341-347. DOI: 10.1007/s15010-018-1124-6. View

20.

Spinner C, Lang G, Boesecke C, Jessen H, Schewe K . Summary of German-Austrian HIV PrEP guideline. HIV Med. 2019; 20(6):368-376. DOI: 10.1111/hiv.12724. View