About half of U.S. health care providers who exhibited high levels of motivation to learn more about HIV care provision reported that they had never prescribed PrEP, according to results from a survey conducted in 2015 and reported recently in PLOS One.
The survey data were obtained from 519 independent medication prescribers who were considered highly motivated due to their participation in a CME advanced-level HIV course, which took place in one of five large U.S. cities. Only 54% of these motivated clinicians reported that they had prescribed PrEP.
That percentage is significantly higher than the proportion of all health care providers who have prescribed biomedical HIV prevention, but given their level of engagement in HIV care, the proportion is still too low for PrEP to have a major impact on U.S. HIV infection rates, the authors contend.
Internal medicine physicians were 1.6 times more likely to report prescribing PrEP than infectious disease specialists, possibly because the specialists mostly see people already living with HIV. This finding underscores the importance of primary care providers for HIV risk assessment, the authors noted.
When evaluating clinical vignettes, internists were twice as likely as ID docs to consider PrEP a first step for people who inject drugs. Participants who saw biomedical HIV prevention as the first option for MSM were almost six times more likely to consider it for PWID than those who did not hold that view.
PrEP prescribing may have been limited by structural factors, such as financial barriers due to insurance restrictions, the researchers cautioned.
"With a U.S. policy goal to eradicate HIV by 2030, practitioners are central to ensuring the delivery of PrEP across care settings," study lead Ashley Leech, Ph.D., noted in a press release. To that end, motivated prescribers such as the study’s participants could be targeted to address uncertainties around biomedical prevention, the study authors concluded.