Knowledge needs for implementing HIV pre-exposure prophylaxis among primary care providers in a safety-net health system
| Autor: | Kevin J. Craten, Afiba Manza-A. Agovi, Matthew J. Cvitanovich, Rohit P. Ojha, Ifedioranma Anikpo, Eve O. Asuelime |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Safety net Human immunodeficiency virus (HIV) lcsh:Medicine 030209 endocrinology & metabolism Health Informatics Primary care medicine.disease_cause Logistic regression Odds 03 medical and health sciences Pre-exposure prophylaxis 0302 clinical medicine Intervention (counseling) medicine 030212 general & internal medicine Primary Care business.industry Prevention lcsh:R Public Health Environmental and Occupational Health HIV Regular Article Odds ratio Family medicine Implementation business Safety-net |
| Zdroj: | Preventive Medicine Reports, Vol 20, Iss, Pp 101266-(2020) Preventive Medicine Reports |
| ISSN: | 2211-3355 |
| Popis: | Highlights • Little is known about barriers to PrEP prescribing in safety-net settings. • We identified low provider knowledge of PrEP as a barrier to PrEP prescribing. • PrEP eligibility, side effects and adherence concerns were key unmet knowledge needs. Safety-net health systems are a primary source of care for socioeconomically disadvantaged individuals who may be eligible for HIV pre-exposure prophylaxis (PrEP) and are priority groups under the Ending the HIV Epidemic (EHE) initiative. Nevertheless, little evidence is available about barriers to PrEP implementation in safety-net settings. We aimed to assess the association between PrEP knowledge and prescribing practices, and to ascertain unmet knowledge needs to implement PrEP. In 2019, we surveyed primary care providers (PCPs) in a safety-net health system that serves an EHE priority jurisdiction located in North Texas. Our questionnaire ascertained self-reported prescribing practices, knowledge, and training needs related to PrEP. We used penalized logistic regression to estimate odds ratio (OR) and 95% posterior limits (PL) for the association between provider self-rated knowledge of PrEP and PrEP prescribing. Our study population comprised 62 primary care providers, of whom 61% were female, 60% were non-Hispanic White, 76% were physicians (76%), 57% had ≥ 10 years of practice experience, 45% reported low self-rated PrEP knowledge, and 35% prescribed PrEP in the past year. Providers with low PrEP knowledge had 69% lower odds of prescribing PrEP within the past year (OR = 0.31, 95% PL: 0.12, 0.82). Eligibility for PrEP, side effects and adherence concerns were key unmet knowledge needs. Our findings suggest that low provider PrEP knowledge may be a barrier to PrEP prescribing among safety-net PCPs. Our results provide insight about specific educational needs of PCPs in a safety-net health system, which are amenable to educational intervention. |
| Databáze: | OpenAIRE |
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