An educational initiative in response to identified PrEP prescribing needs among PCPs in the Southern U.S.

ABSTRACT

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, but many primary care physicians (PCPs) have not incorporated PrEP into practice. While PrEP may be a key strategy to reducing high HIV transmission rates in the southern US, knowledge about PrEP prescribing patterns among PCPs in this region is lacking. An online survey was sent to a large network of PCPs at an academic medical center in North Carolina in October 2015. The survey was repeated in September 2016, after an educational intervention that included on-site trainings at 14 PCP offices. Chi-square tests were used to compare PrEP prescribing patterns among providers. The initial survey was sent to 389 PCPs, with 115 (30%) responding. Of these, 78% reported seeing men who have sex with men (MSM). Only 17% had prescribed PrEP. The most frequently identified barrier was lack of knowledge (60%). When the survey was repeated after the educational initiative, 79 PCPs (20%) responded. Of these, 90% reported seeing MSM, and 35% had prescribed PrEP. PCPs who had attended a training were more likely to have prescribed PrEP (OR 4.84, CI 1.77–13.21). In conclusion, PrEP prescribing among PCPs in the southern US is low. A survey among PCPs identified lack of knowledge as a barrier to prescribing, motivating an institutional-wide educational campaign in response. Further efforts are needed to continue to raise awareness and educate PCPs in the South about PrEP.

KEYWORDS:

• Pre-exposure prophylaxis
• PrEP
• primary care providers
• PCPs
• southern United States

Acknowledgements

We would like to thank Kevin Shah, MD, MBA, and John Anderson, MD of Duke Primary Care for assisting us with survey dissemination and coordination of training sessions.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

N. Lance Okeke http://orcid.org/0000-0003-4456-0176

Additional information

Funding

The publication resulted (in part) from research supported by the Duke University Center for AIDS Research (CFAR), an NIH funded program [grant number 5P30 AI064518]. An abstract of this work was presented by Dr. Seidelman at AIDS 2016 in Durban, South Africa in July of last year. Support for this effort was provided by the Interdisciplinary Research Training Program in AIDS training [grant number 5T32AI007392-25] to MEC.; National Institute of Allergy and Infectious Diseases.