Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training
There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping...
Main Authors: | , , , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
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SAGE Publishing
2021-05-01
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Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
Online Access: | https://doi.org/10.1177/00469580211017666 |
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author | Robert L. Cooper PhD, MSSW Paul D. Juarez PhD Matthew C. Morris PhD Aramandla Ramesh PhD Ryan Edgerton MPH Lauren L. Brown PhD, LCSW, MSSW Leandro Mena MD Samuel A. MacMaster PhD Shavonne Collins MD Patricia Matthews- Juarez PhD Mohammad Tabatabai PhD Katherine Y. Brown EdD Michael J. Paul MPH Wansoo Im PhD Thomas A. Arcury PhD Marybeth Shinn PhD |
author_facet | Robert L. Cooper PhD, MSSW Paul D. Juarez PhD Matthew C. Morris PhD Aramandla Ramesh PhD Ryan Edgerton MPH Lauren L. Brown PhD, LCSW, MSSW Leandro Mena MD Samuel A. MacMaster PhD Shavonne Collins MD Patricia Matthews- Juarez PhD Mohammad Tabatabai PhD Katherine Y. Brown EdD Michael J. Paul MPH Wansoo Im PhD Thomas A. Arcury PhD Marybeth Shinn PhD |
author_sort | Robert L. Cooper PhD, MSSW |
collection | DOAJ |
description | There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision. Four overarching barriers presented in the literature: Purview Paradox, Patient Financial Constraints, Risk Compensation, and Concern for ART Resistance. Considering the physician-identified barriers, we make recommendations for how physicians and students may work to increase PrEP knowledge and competence along each stage of the PrEP cascade. We recommend adopting HIV risk assessment as a standard of care, improving physician ability to identify PrEP candidates, improving physician interest and ability in encouraging PrEP uptake, and increasing utilization of continuous care management to ensure retention and adherence to PrEP. |
first_indexed | 2024-12-22T00:03:19Z |
format | Article |
id | doaj.art-40c4de7970be495c9e72687bd5d2ac89 |
institution | Directory Open Access Journal |
issn | 0046-9580 1945-7243 |
language | English |
last_indexed | 2024-12-22T00:03:19Z |
publishDate | 2021-05-01 |
publisher | SAGE Publishing |
record_format | Article |
series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
spelling | doaj.art-40c4de7970be495c9e72687bd5d2ac892022-12-21T18:45:37ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432021-05-015810.1177/00469580211017666Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student TrainingRobert L. Cooper PhD, MSSW0Paul D. Juarez PhD1Matthew C. Morris PhD2Aramandla Ramesh PhD3Ryan Edgerton MPH4Lauren L. Brown PhD, LCSW, MSSW5Leandro Mena MD6Samuel A. MacMaster PhD7Shavonne Collins MD8Patricia Matthews- Juarez PhD9Mohammad Tabatabai PhD10Katherine Y. Brown EdD11Michael J. Paul MPH12Wansoo Im PhD13Thomas A. Arcury PhD14Marybeth Shinn PhD15Meharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAUniversity of Mississippi Medical Center, Jackson, MS, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USABehavioral Health & Research at Nashville Cares, Nashville, TN, USAUniversity of Mississippi Medical Center, Jackson, MS, USABaylor College of Medicine in Houston, Houston, TX, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAWake Forest School of Medicine, Winston-Salem, NC, USAVanderbilt University, Nashville, TN, USAThere is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision. Four overarching barriers presented in the literature: Purview Paradox, Patient Financial Constraints, Risk Compensation, and Concern for ART Resistance. Considering the physician-identified barriers, we make recommendations for how physicians and students may work to increase PrEP knowledge and competence along each stage of the PrEP cascade. We recommend adopting HIV risk assessment as a standard of care, improving physician ability to identify PrEP candidates, improving physician interest and ability in encouraging PrEP uptake, and increasing utilization of continuous care management to ensure retention and adherence to PrEP.https://doi.org/10.1177/00469580211017666 |
spellingShingle | Robert L. Cooper PhD, MSSW Paul D. Juarez PhD Matthew C. Morris PhD Aramandla Ramesh PhD Ryan Edgerton MPH Lauren L. Brown PhD, LCSW, MSSW Leandro Mena MD Samuel A. MacMaster PhD Shavonne Collins MD Patricia Matthews- Juarez PhD Mohammad Tabatabai PhD Katherine Y. Brown EdD Michael J. Paul MPH Wansoo Im PhD Thomas A. Arcury PhD Marybeth Shinn PhD Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training Inquiry: The Journal of Health Care Organization, Provision, and Financing |
title | Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training |
title_full | Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training |
title_fullStr | Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training |
title_full_unstemmed | Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training |
title_short | Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training |
title_sort | recommendations for increasing physician provision of pre exposure prophylaxis implications for medical student training |
url | https://doi.org/10.1177/00469580211017666 |
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