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Healthcare practitioner experiences and willingness to prescribe pre-exposure prophylaxis in the US

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  • Ashley A Leech
  • Cindy L Christiansen
  • Benjamin P Linas
  • Donna M Jacobsen
  • Isabel Morin
  • Mari-Lynn Drainoni

Abstract

Background and objectives: Less than 10 percent of the more than one million people vulnerable to HIV are using pre-exposure prophylaxis (PrEP). Practitioners are critical to ensuring the delivery of PrEP across care settings. In this study, we target a group of prescribers focused on providing HIV care and seeking up-to-date information about HIV. We assessed their experiences prescribing PrEP, whether these experiences differed by clinical specialty, and examined associations between willingness to prescribe PrEP as a “best first step” and different hypothetical prescribing scenarios. Setting and methods: Between March and May 2015, we circulated a paper survey to 954 participants ((652 of whom met our inclusion criteria of being independent prescribers and 519 of those (80%) responded to the survey)) at continuing medical education advanced-level HIV courses in five locations across the US on practitioner practices and preferences of PrEP. We employed multivariable logistic regression analysis for binary and collapsed ordinal outcomes. Results: Among this highly motivated group of practitioners, only 54% reported ever prescribing PrEP. Internal medicine practitioners were 1.6 times more likely than infectious disease practitioners to have prescribed PrEP (95% CI: 0.99–2.60, p = .0524) and age, years of training, and sex were significantly associated with prescribing experience. Based on clinical vignettes describing different hypothetical prescribing scenarios, practitioners who viewed PrEP as the first clinical step for persons who inject drugs (PWID) were twice as likely to have also considered PrEP as the first clinical option for safer conception, and vice-a-versa (95% CI: 1.4–3.2, p

Suggested Citation

  • Ashley A Leech & Cindy L Christiansen & Benjamin P Linas & Donna M Jacobsen & Isabel Morin & Mari-Lynn Drainoni, 2020. "Healthcare practitioner experiences and willingness to prescribe pre-exposure prophylaxis in the US," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-12, September.
    • Handle: RePEc:plo:pone00:0238375
    DOI: 10.1371/journal.pone.0238375
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    1. Valentin Amrhein & Sander Greenland & Blake McShane, 2019. "Scientists rise up against statistical significance," Nature, Nature, vol. 567(7748), pages 305-307, March.
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