Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers
Primary care physicians (PCPs) are critical for promoting HIV prevention by prescribing pre-exposure prophylaxis (PrEP). Yet, there are limited data regarding PCP’s preferred approaches for PrEP implementation. In 2015, we conducted an online survey of PCPs’ PrEP prescribing and implementation. Part...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-03-01
|
| Series: | Preventive Medicine Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335519301834 |
| _version_ | 1818575173591236608 |
|---|---|
| author | E. Jennifer Edelman Brent A. Moore Sarah K. Calabrese Gail Berkenblit Chinazo O. Cunningham Onyema Ogbuagu Viraj V. Patel Karran A. Phillips Jeanette M. Tetrault Minesh Shah Oni Blackstock |
| author_facet | E. Jennifer Edelman Brent A. Moore Sarah K. Calabrese Gail Berkenblit Chinazo O. Cunningham Onyema Ogbuagu Viraj V. Patel Karran A. Phillips Jeanette M. Tetrault Minesh Shah Oni Blackstock |
| author_sort | E. Jennifer Edelman |
| collection | DOAJ |
| description | Primary care physicians (PCPs) are critical for promoting HIV prevention by prescribing pre-exposure prophylaxis (PrEP). Yet, there are limited data regarding PCP’s preferred approaches for PrEP implementation. In 2015, we conducted an online survey of PCPs’ PrEP prescribing and implementation. Participants were general internists recruited from a national professional organization. We examined provider and practice characteristics and perceived implementation barriers and facilitators associated with preferred models for PrEP implementation. Among 240 participants, the majority (85%) favored integrating PrEP into primary care, either by training all providers (“all trained”) (42%) or having an onsite PrEP specialist (“on-site specialist”) (43%). Only 15% preferred referring patients out of the practice to a specialist (“refer out”). Compared to those who preferred to “refer out,” participants who preferred the “all trained” model were more likely to spend most of their time delivering direct patient care and to practice in the Northeast. Compared to participants who preferred the “refer out” or on-site specialist” models, PCPs preferring the all trained model were less likely to perceive lack of clinic PrEP guidelines/protocols as a barrier to PrEP. Most PCPs favored integrating PrEP into primary care by either training all providers or having an on-site specialist. Time devoted to clinical care and geography may influence preferences for PrEP implementation. Establishing clinic-specific PrEP protocols may promote on-site PrEP implementation. Future studies should focus on evaluating the effectiveness of different PrEP implementation models on PrEP delivery. Keywords: HIV prevention, Implementation, Pre-exposure prophylaxis, Primary care physicians |
| first_indexed | 2024-12-15T00:36:45Z |
| format | Article |
| id | doaj.art-2936aa7f1c404759951f860d0752e66c |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-12-15T00:36:45Z |
| publishDate | 2020-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-2936aa7f1c404759951f860d0752e66c2022-12-21T22:41:46ZengElsevierPreventive Medicine Reports2211-33552020-03-0117Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providersE. Jennifer Edelman0Brent A. Moore1Sarah K. Calabrese2Gail Berkenblit3Chinazo O. Cunningham4Onyema Ogbuagu5Viraj V. Patel6Karran A. Phillips7Jeanette M. Tetrault8Minesh Shah9Oni Blackstock10Yale, New Haven, CT, United States; Corresponding author at: Yale University, School of Medicine and Public Health, 367 Cedar Street, E.S. Harkness Memorial Hall, Building A, Suite 401, New Haven, CT 06510 203.737.7115, United States.Yale, New Haven, CT, United StatesYale, New Haven, CT, United States; George Washington University, Washington, DC, United StatesJohns Hopkins, Baltimore, MD, United StatesAlbert Einstein College of Medicine, Montefiore Health System, Bronx, NY, United StatesYale, New Haven, CT, United StatesAlbert Einstein College of Medicine, Montefiore Health System, Bronx, NY, United StatesNIDA-IRP, NIH, Baltimore, MD, United StatesYale, New Haven, CT, United StatesUIC, Chicago, IL, United StatesAlbert Einstein College of Medicine, Montefiore Health System, Bronx, NY, United StatesPrimary care physicians (PCPs) are critical for promoting HIV prevention by prescribing pre-exposure prophylaxis (PrEP). Yet, there are limited data regarding PCP’s preferred approaches for PrEP implementation. In 2015, we conducted an online survey of PCPs’ PrEP prescribing and implementation. Participants were general internists recruited from a national professional organization. We examined provider and practice characteristics and perceived implementation barriers and facilitators associated with preferred models for PrEP implementation. Among 240 participants, the majority (85%) favored integrating PrEP into primary care, either by training all providers (“all trained”) (42%) or having an onsite PrEP specialist (“on-site specialist”) (43%). Only 15% preferred referring patients out of the practice to a specialist (“refer out”). Compared to those who preferred to “refer out,” participants who preferred the “all trained” model were more likely to spend most of their time delivering direct patient care and to practice in the Northeast. Compared to participants who preferred the “refer out” or on-site specialist” models, PCPs preferring the all trained model were less likely to perceive lack of clinic PrEP guidelines/protocols as a barrier to PrEP. Most PCPs favored integrating PrEP into primary care by either training all providers or having an on-site specialist. Time devoted to clinical care and geography may influence preferences for PrEP implementation. Establishing clinic-specific PrEP protocols may promote on-site PrEP implementation. Future studies should focus on evaluating the effectiveness of different PrEP implementation models on PrEP delivery. Keywords: HIV prevention, Implementation, Pre-exposure prophylaxis, Primary care physicianshttp://www.sciencedirect.com/science/article/pii/S2211335519301834 |
| spellingShingle | E. Jennifer Edelman Brent A. Moore Sarah K. Calabrese Gail Berkenblit Chinazo O. Cunningham Onyema Ogbuagu Viraj V. Patel Karran A. Phillips Jeanette M. Tetrault Minesh Shah Oni Blackstock Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers Preventive Medicine Reports |
| title | Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers |
| title_full | Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers |
| title_fullStr | Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers |
| title_full_unstemmed | Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers |
| title_short | Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers |
| title_sort | preferences for implementation of hiv pre exposure prophylaxis prep results from a survey of primary care providers |
| url | http://www.sciencedirect.com/science/article/pii/S2211335519301834 |
| work_keys_str_mv | AT ejenniferedelman preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT brentamoore preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT sarahkcalabrese preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT gailberkenblit preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT chinazoocunningham preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT onyemaogbuagu preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT virajvpatel preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT karranaphillips preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT jeanettemtetrault preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT mineshshah preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders AT oniblackstock preferencesforimplementationofhivpreexposureprophylaxisprepresultsfromasurveyofprimarycareproviders |