Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers

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

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article number101012
JournalPreventive Medicine Reports
Volume17
DOIs
StatePublished - Mar 2020

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Keywords

  • HIV prevention
  • Implementation
  • Pre-exposure prophylaxis
  • Primary care physicians

ASJC Scopus subject areas

  • Health Informatics
  • Public Health, Environmental and Occupational Health

Cite this

Edelman, E. J., Moore, B. A., Calabrese, S. K., Berkenblit, G., Cunningham, C. O., Ogbuagu, O., Patel, V. V., Phillips, K. A., Tetrault, J. M., Shah, M., & Blackstock, O. (2020). Preferences for implementation of HIV pre-exposure prophylaxis (PrEP): Results from a survey of primary care providers. Preventive Medicine Reports, 17, [101012]. https://doi.org/10.1016/j.pmedr.2019.101012