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Enhancing HIV Pre-exposure Prophylaxis Practices via an Educational Intervention

Newman, Rebecca MD; Katchi, Tasleem MD; Karass, Michael MD; Gennarelli, Melissa MD; Goutis, Jason MD; Kifayat, Alina MD; Solanki, Shantanu MD; Yandrapalli, Srikanth MD; Forman, Leanne MD; Nabors, Christopher MD, PhD*

doi: 10.1097/MJT.0000000000000773
Original Investigation
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Background: Pre-exposure prophylaxis (PrEP) for HIV involves using antiretroviral drugs to prevent individuals at high risk from acquiring HIV infection. Most practicing primary care providers believe PrEP to be safe and effective, but less than half have prescribed or referred for PrEP. Attitudes and prescribing patterns among house officers have not been well described previously.

Study Question: Can an educational intervention enhance HIV PrEP practices among internal medicine house officers?

Study Design: This study relied on a pretest/posttest design. All categorical trainees at a medium-sized internal medicine program were offered a baseline survey to assess their knowledge on PrEP. This was followed by a PrEP-focused educational intervention and a postintervention survey.

Measures and Outcomes: Likert scales captured perceptions regarding safety, effectiveness, barriers, factors that would promote PrEP use, potential side effects, impact on risk-taking behavior, and provider comfort level in assessing behavioral risks and in PrEP prescribing. Data were analyzed using descriptive statistics, Wilcoxon signed rank test, and the Kruskal–Wallis test. Significance was accepted for P < 0.05.

Results: Forty-eight (100%) trainees participated in the educational session, 45 (94%) in a preintervention survey, and 36 (75%) in a postintervention survey. Before PrEP training, 22% of respondents were unaware of PrEP, 78% believed PrEP was effective, 66% believed PrEP was safe, 62% had fair or poor awareness of side effects; 18% of residents had referred for or prescribed PrEP, and 31% believed they were likely to prescribe PrEP in the next 6 months. After the intervention, 94% of trainees believed PrEP was effective (P < 0.001), 92% believed PrEP was safe (P < 0.001), and two-thirds believed they were likely to prescribe PrEP in the next 6 months.

Conclusions: Brief, focused training on HIV prevention promotes awareness, acceptance, and likelihood of prescribing PrEP by internal medicine trainees.

Division of Internal Medicine, New York Medical College, Westchester Medical Center, Valhalla, NY.

Address for correspondence: Assistant Professor of Medicine, Division of Internal Medicine, New York Medical College, Westchester Medical Center, 95 Grasslands Road, Valhalla, NY 10595. E-mail: Christopher_Nabors@nymc.edu

The authors have no conflicts of interest to declare.

All authors contributed in various degrees in review of the study, in writing and editing the manuscript; article type; key words; and running head.

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