Knowledge, Sex, and Region Associated with Primary Care Providers Prescribing Adolescents HIV Pre-exposure Prophylaxis

Overview

Journal Sci Rep

Specialty Science

Date 2023 Oct 8

PMID 37806978

Authors

Garrett Price

Randolph D Hubach

Joseph M Currin

Christopher Owens

Affiliations

Soon will be listed here.

Abstract

Although HIV pre-exposure prophylaxis (PrEP) effectively and safely prevents HIV among adolescents, uptake of PrEP is low. Adolescents must have primary care providers (PCPs) prescribe them PrEP, making PCPs critical actors in PrEP delivery. However, research has primarily investigated determinants of PCPs' intention to prescribe adolescents PrEP rather than the determinants of performing the behavior itself. We examined the demographic, clinical practice, and implementation determinants of PCPs previously prescribing PrEP to adolescents. PCPs were recruited from a national Qualtrics panel of licensed medical providers in the United States from July 15-August 19, 2022. The Theoretical Domains Framework informed the implementation determinants measured. A multivariable logistic regression was used. PCPs who were more knowledgeable of the CDC guidelines (aOR 2.97, 95% CI 2.16-4.10), who were assigned male at birth (aOR 1.64, 95% CI 1.03-2.59), and who practiced in the Western region (aOR 1.85, 95% CI 1.04-3.30) had greater odds of prior prescribing adolescents PrEP. Provider-based educational interventions should be designed, implemented, and tested to encourage PCPs to prescribe PrEP to eligible adolescents.

References

Fauci A, Redfield R, Sigounas G, Weahkee M, Giroir B . Ending the HIV Epidemic: A Plan for the United States. JAMA. 2019; 321(9):844-845. DOI: 10.1001/jama.2019.1343. View

Barry M, Nicholson W, Silverstein M, Chelmow D, Coker T, Davis E . Preexposure Prophylaxis to Prevent Acquisition of HIV: US Preventive Services Task Force Recommendation Statement. JAMA. 2023; 330(8):736-745. DOI: 10.1001/jama.2023.14461. View

Siegler A, Mehta C, Mouhanna F, Mera Giler R, Castel A, Pembleton E . Policy- and county-level associations with HIV pre-exposure prophylaxis use, the United States, 2018. Ann Epidemiol. 2020; 45:24-31.e3. PMC: 7246022. DOI: 10.1016/j.annepidem.2020.03.013. View

Siegler A, Mouhanna F, Mera Giler R, Weiss K, Pembleton E, Guest J . The prevalence of pre-exposure prophylaxis use and the pre-exposure prophylaxis-to-need ratio in the fourth quarter of 2017, United States. Ann Epidemiol. 2018; 28(12):841-849. PMC: 6286209. DOI: 10.1016/j.annepidem.2018.06.005. View

Sullivan P, Mera Giler R, Mouhanna F, Pembleton E, Guest J, Jones J . Trends in the use of oral emtricitabine/tenofovir disoproxil fumarate for pre-exposure prophylaxis against HIV infection, United States, 2012-2017. Ann Epidemiol. 2018; 28(12):833-840. PMC: 6286244. DOI: 10.1016/j.annepidem.2018.06.009. View

Sullivan P, Mouhanna F, Mera R, Pembleton E, Castel A, Jaggi C . Methods for county-level estimation of pre-exposure prophylaxis coverage and application to the U.S. Ending the HIV Epidemic jurisdictions. Ann Epidemiol. 2020; 44:16-30. DOI: 10.1016/j.annepidem.2020.01.004. View

Hart-Cooper G, Allen I, Irwin Jr C, Scott H . Adolescent Health Providers' Willingness to Prescribe Pre-Exposure Prophylaxis (PrEP) to Youth at Risk of HIV Infection in the United States. J Adolesc Health. 2018; 63(2):242-244. DOI: 10.1016/j.jadohealth.2018.03.016. View

Mullins T, Idoine C, Zimet G, Kahn J . Primary Care Physician Attitudes and Intentions Toward the Use of HIV Pre-exposure Prophylaxis in Adolescents in One Metropolitan Region. J Adolesc Health. 2018; 64(5):581-588. PMC: 6478546. DOI: 10.1016/j.jadohealth.2018.10.300. View

Mullins T, Lally M, Zimet G, Kahn J . Clinician attitudes toward CDC interim pre-exposure prophylaxis (PrEP) guidance and operationalizing PrEP for adolescents. AIDS Patient Care STDS. 2015; 29(4):193-203. PMC: 4378662. DOI: 10.1089/apc.2014.0273. View

10.

Mullins T, Zimet G, Lally M, Kahn J . Adolescent Human Immunodeficiency Virus Care Providers' Attitudes Toward the Use of Oral Pre-Exposure Prophylaxis in Youth. AIDS Patient Care STDS. 2016; 30(7):339-48. PMC: 4948218. DOI: 10.1089/apc.2016.0048. View

11.

Mullins T, Zimet G, Lally M, Xu J, Thornton S, Kahn J . HIV Care Providers' Intentions to Prescribe and Actual Prescription of Pre-Exposure Prophylaxis to At-Risk Adolescents and Adults. AIDS Patient Care STDS. 2017; 31(12):504-516. PMC: 5724583. DOI: 10.1089/apc.2017.0147. View

12.

Pina P, Taggart T, Sanchez Acosta M, Eweka I, Munoz-Laboy M, Albritton T . Provider Comfort with Prescribing HIV Pre-Exposure Prophylaxis to Adolescents. AIDS Patient Care STDS. 2021; 35(10):411-417. PMC: 8665811. DOI: 10.1089/apc.2021.0045. View

13.

Valente P, Rusley J, Operario D, Biello K . Readiness to Provide Oral and Injectable PrEP for Sexual and Gender Minority Youth Among Healthcare Providers and Clinics in the U.S. Northeast. J Adolesc Health. 2023; 72(5):722-729. PMC: 10121770. DOI: 10.1016/j.jadohealth.2022.11.246. View

14.

Owens C, Currin J, Hoffman M, Grant M, Hubach R . Implementation Factors Associated With Primary Care Providers' Intention to Prescribe HIV PrEP to Adolescents in the United States. J Adolesc Health. 2023; 73(1):181-189. DOI: 10.1016/j.jadohealth.2023.02.007. View

15.

Zhang C, McMahon J, Fiscella K, Przybyla S, Braksmajer A, Leblanc N . HIV Pre-Exposure Prophylaxis Implementation Cascade Among Health Care Professionals in the United States: Implications from a Systematic Review and Meta-Analysis. AIDS Patient Care STDS. 2019; 33(12):507-527. PMC: 6918849. DOI: 10.1089/apc.2019.0119. View

16.

Blumenthal J, Jain S, Krakower D, Sun X, Young J, Mayer K . Knowledge is Power! Increased Provider Knowledge Scores Regarding Pre-exposure Prophylaxis (PrEP) are Associated with Higher Rates of PrEP Prescription and Future Intent to Prescribe PrEP. AIDS Behav. 2015; 19(5):802-10. PMC: 4417031. DOI: 10.1007/s10461-015-0996-z. View

17.

Seidman D, Carlson K, Weber S, Witt J, Kelly P . United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey. Contraception. 2016; 93(5):463-9. DOI: 10.1016/j.contraception.2015.12.018. View

18.

Clement M, Seidelman J, Wu J, Alexis K, McGee K, Okeke N . An educational initiative in response to identified PrEP prescribing needs among PCPs in the Southern U.S. AIDS Care. 2017; 30(5):650-655. PMC: 6612371. DOI: 10.1080/09540121.2017.1384534. View

19.

Calabrese S, Krakower D, Rao S, Hansen N, Mayer K, Magnus M . Acceptability and Effectiveness of a One-Hour Healthcare Provider Intervention Integrating HIV Pre-Exposure Prophylaxis and Cultural Competence Training. AIDS Behav. 2023; 27(12):3932-3940. PMC: 10906281. DOI: 10.1007/s10461-023-04108-x. View

20.

Armstrong M, Nigh E, Gill-Wiehl G, Doblecki-Lewis S . Medical Students' Perspectives on HIV Prevention Education in the Preclinical Years. AIDS Res Hum Retroviruses. 2018; 34(10):817-819. DOI: 10.1089/AID.2018.0085. View