How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium

Introduction:In Belgium, the provision of pre-exposure prophylaxis (PrEP) for HIV prevention is centralized in specialized HIV clinics. Engaging family physicians in PrEP care could help scale-up its delivery and reach underserved populations. The objective of this study was to gain insight into fam...

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Main Authors: Jef Vanhamel, Thijs Reyniers, Edwin Wouters, Josefien van Olmen, Thibaut Vanbaelen, Christiana Nöstlinger, Heleen Van Mieghem, Ella Van Landeghem, Anke Rotsaert, Marie Laga, Bea Vuylsteke
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-03-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2022.828695/full
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author Jef Vanhamel
Thijs Reyniers
Edwin Wouters
Josefien van Olmen
Thibaut Vanbaelen
Christiana Nöstlinger
Heleen Van Mieghem
Ella Van Landeghem
Anke Rotsaert
Marie Laga
Bea Vuylsteke
author_facet Jef Vanhamel
Thijs Reyniers
Edwin Wouters
Josefien van Olmen
Thibaut Vanbaelen
Christiana Nöstlinger
Heleen Van Mieghem
Ella Van Landeghem
Anke Rotsaert
Marie Laga
Bea Vuylsteke
author_sort Jef Vanhamel
collection DOAJ
description Introduction:In Belgium, the provision of pre-exposure prophylaxis (PrEP) for HIV prevention is centralized in specialized HIV clinics. Engaging family physicians in PrEP care could help scale-up its delivery and reach underserved populations. The objective of this study was to gain insight into family physicians' self-perceived roles in providing PrEP.MethodsWe conducted 16 online group discussions with a total of 105 Flemish family physicians, between November 2020 and February 2021. A brief online questionnaire assessed their socio-demographics and experience with sexual health. We analyzed verbatim transcribed data using a grounded theory approach.ResultsDespite limited awareness and experience, participants reported a high willingness to be more actively involved in PrEP care. Four potential roles for the family physician in PrEP care were identified: acting as low-threshold entry point for advice; opportunistic case finding of PrEP candidates; initiating appropriate care for PrEP-eligible clients; and ensuring high-quality follow-up care for PrEP users. Participants framed each of these roles within their current activities and responsibilities as primary care providers. Yet, participants differed in their views on the concrete operationalization of these roles, and in the extent of their involvement in PrEP. Particular challenges were a lack of experience with antiretrovirals, perceived limited exposure to clients at high HIV risk, and a lack of expertise and resources to conduct time-intensive risk assessments and counseling related to PrEP.ConclusionBelgian family physicians demonstrated a keen willingness to be involved in PrEP care, but had differing views on the practical implementation into their practices. Providing tailored training on sexual health and PrEP, and investing in collaboration between primary and secondary care, could optimize the integration of PrEP in the primary care practice.
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spelling doaj.art-b4a20d9b578141dba8c361257639ca5f2022-12-22T03:13:31ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-03-01910.3389/fmed.2022.828695828695How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, BelgiumJef Vanhamel0Thijs Reyniers1Edwin Wouters2Josefien van Olmen3Thibaut Vanbaelen4Christiana Nöstlinger5Heleen Van Mieghem6Ella Van Landeghem7Anke Rotsaert8Marie Laga9Bea Vuylsteke10Department of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Sociology, University of Antwerp, Antwerp, BelgiumDepartment of Family Medicine and Population Health, University of Antwerp, Antwerp, BelgiumDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumIntroduction:In Belgium, the provision of pre-exposure prophylaxis (PrEP) for HIV prevention is centralized in specialized HIV clinics. Engaging family physicians in PrEP care could help scale-up its delivery and reach underserved populations. The objective of this study was to gain insight into family physicians' self-perceived roles in providing PrEP.MethodsWe conducted 16 online group discussions with a total of 105 Flemish family physicians, between November 2020 and February 2021. A brief online questionnaire assessed their socio-demographics and experience with sexual health. We analyzed verbatim transcribed data using a grounded theory approach.ResultsDespite limited awareness and experience, participants reported a high willingness to be more actively involved in PrEP care. Four potential roles for the family physician in PrEP care were identified: acting as low-threshold entry point for advice; opportunistic case finding of PrEP candidates; initiating appropriate care for PrEP-eligible clients; and ensuring high-quality follow-up care for PrEP users. Participants framed each of these roles within their current activities and responsibilities as primary care providers. Yet, participants differed in their views on the concrete operationalization of these roles, and in the extent of their involvement in PrEP. Particular challenges were a lack of experience with antiretrovirals, perceived limited exposure to clients at high HIV risk, and a lack of expertise and resources to conduct time-intensive risk assessments and counseling related to PrEP.ConclusionBelgian family physicians demonstrated a keen willingness to be involved in PrEP care, but had differing views on the practical implementation into their practices. Providing tailored training on sexual health and PrEP, and investing in collaboration between primary and secondary care, could optimize the integration of PrEP in the primary care practice.https://www.frontiersin.org/articles/10.3389/fmed.2022.828695/fullpre-exposure prophylaxisHIV preventionfamily physiciansprimary careservice delivery
spellingShingle Jef Vanhamel
Thijs Reyniers
Edwin Wouters
Josefien van Olmen
Thibaut Vanbaelen
Christiana Nöstlinger
Heleen Van Mieghem
Ella Van Landeghem
Anke Rotsaert
Marie Laga
Bea Vuylsteke
How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium
Frontiers in Medicine
pre-exposure prophylaxis
HIV prevention
family physicians
primary care
service delivery
title How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium
title_full How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium
title_fullStr How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium
title_full_unstemmed How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium
title_short How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium
title_sort how do family physicians perceive their role in providing pre exposure prophylaxis for hiv prevention an online qualitative study in flanders belgium
topic pre-exposure prophylaxis
HIV prevention
family physicians
primary care
service delivery
url https://www.frontiersin.org/articles/10.3389/fmed.2022.828695/full
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