HIV post-exposure prophylaxis in the emergency department: An updated assessment and opportunities for HIV prevention identified
| Autor: | Katie A O'Connell, Laila A. Moraczewski, Catherine J. Derber, Bruce M. Lo, Joshua Edwards, Alice V. Kisteneff, Shanedeep S. Gill, William Sherrerd-Smith |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Health Knowledge Attitudes Practice Delphi Technique HIV post exposure prophylaxis medicine.medical_treatment Human immunodeficiency virus (HIV) Modified delphi Unprotected sex HIV Infections medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Medicine Humans Physician assistants Post-exposure prophylaxis business.industry 030208 emergency & critical care medicine General Medicine Emergency department Regimen Family medicine Emergency Medicine Female business Emergency Service Hospital Post-Exposure Prophylaxis |
| Zdroj: | The American journal of emergency medicine. 46 |
| ISSN: | 1532-8171 |
| Popis: | Objectives Research suggests nonoccupational post exposure prophylaxis (nPEP) is under prescribed for people seeking treatment within 72 h of human immunodeficiency virus (HIV) exposures in the emergency department (ED). This study is an assessment of ED prescribers' knowledge, attitudes and practices regarding administration of HIV nPEP. Methods This was an anonymous survey based on literature review and modified Delphi technique. We approached 153 ED participants at work over a 4-month period from 5 hospital-based and 2 freestanding EDs. There were 152 completed surveys: 80 attendings, 27 residents, and 44 physician assistants. Results The majority of those surveyed (133/149, 89.3%) believe it is their responsibility to provide HIV nPEP in the ED. Although 91% (138/151) and 87% (132/151) of participants are willing to prescribe nPEP for IV drug use and unprotected sex, respectively, only 40% (61/152) of participants felt they could confidently prescribe the appropriate regimen. Only 25% (37/151) of participants prescribed nPEP in the last year. Participants considered time (27%), connecting patients to follow-up (26%), and cost to patients (23%), as barriers to prescribing nPEP. Conclusions This study identified perceived barriers to administration of nPEP and missed opportunities for HIV prevention in the ED. Although most ED prescribers were willing to prescribe nPEP and felt it is their responsibility to do so, the majority of prescribers were not confident in prescribing it. The most commonly cited barriers to prescribing nPEP were time and access to follow-up care. |
| Databáze: | OpenAIRE |
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