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Original Study

Health Profession Students’ Awareness, Knowledge, and Confidence Regarding Preexposure Prophylaxis: Results of a National, Multidisciplinary Survey

Bunting, Samuel R. BS; Garber, Sarah S. PhD; Goldstein, Robert H. MD, PhD; Calabrese, Sarah K. PhD§; Ritchie, Timothy D. PhD; Batteson, Tamzin J. BSc

Author Information
Sexually Transmitted Diseases: January 2021 - Volume 48 - Issue 1 - p 25-31
doi: 10.1097/OLQ.0000000000001263

In 2017, nearly 40,000 new HIV infections occurred in the United States.1 New infections occur disproportionately among men who have sex with men and racial and ethnic minorities.1 Food and Drug Administration–approval of emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) for oral preexposure prophylaxis (PrEP) in 2012 was a major development in HIV prevention.2 When taken daily, TDF/FTC for PrEP is greater than 90% effective at preventing HIV transmission2–4 and has a favorable safety profile.5,6 In combination with other methods for HIV prevention, PrEP is an essential component of the strategy to end the HIV epidemic.7

Despite its efficacy and safety, prescription of PrEP remains low, especially for racial and ethnic minority people in the United States.8–10 Uptake is also low in transgender women who have sex with men (TWSM), people who inject drugs (PWID), and heterosexual men and women.11,12 Low awareness and knowledge of PrEP among health care practitioners is a factor contributing to the low overall uptake as well as the disparities in PrEP uptake.7,13–28 There are recent reports of missed opportunities to prescribe PrEP to patients with HIV risk factors because of lack of knowledge and confidence among providers in primary care settings.29,30 In addition, a recent study found that patients initiated conversations about PrEP with their health care provider 94% of the time, indicating that providers are missing many opportunities to initiate counseling.15

The National Academy of Medicine predicts a shortage of health care providers properly trained in HIV care and prevention.31s Future health care providers will be called upon to fill this need. Investigating the awareness, education, knowledge, and confidence in skills regarding PrEP for HIV prevention among health professionals in training may provide important insight into the future scale-up of PrEP education and implementation to maximize access among patients at risk for HIV.

We have previously reported on regional variation in the comprehensiveness of education about HIV risk factors and PrEP for HIV prevention.32s To the best of our knowledge, no national studies have investigated knowledge or confidence in skills regarding PrEP in national, interprofessional samples of health profession students. The objective of the present study was to evaluate health profession students' awareness of PrEP, formal education about PrEP, knowledge about PrEP, and confidence in counseling patients and educating colleagues about PrEP.

METHODS

Instrument Distribution

A link to the survey instrument was distributed through membership e-mail lists of health profession student professional societies in the United States between January and July 2019. The following health professions were included: allopathic medicine, osteopathic medicine, pharmacy, undergraduate nursing (bachelor of science in nursing), and physician assistant (PA). The survey was administered online using QualtricsXM (Provo, UT). The present study was conducted as a part of a larger survey that participants completed once, the full details of which have been previously published.32s

Instrument Development

A survey instrument (Appendix 1, https://links.lww.com/OLQ/A540) was developed specifically for this study given the paucity of existing literature. The structure of the survey instrument, including demographic items, was informed by previous research reporting on health care provider knowledge and attitudes toward PrEP.13,16–28 The survey asked whether the student was aware of PrEP at the time of completion of the survey and whether they had received education about PrEP in their academic program (both yes/no). Students were not given information on PrEP before beginning the survey; however, the description of the survey identified that it pertained to PrEP for HIV to avoid confusion with PrEP for other viruses.

Students' knowledge of PrEP was assessed using a series of 6 items based on the Centers for Disease Control and Prevention clinical guidelines (Fig. 1).33s Knowledge items, such as “PrEP is effective at preventing HIV in men who have sex with men” and “PrEP is only used by gay men,” were rated on a 7-point Likert scale (1, completely disagree; 4, neutral; 7, completely agree). This method has been used to analyze knowledge previously.34s–38s Two items evaluated student confidence: “I would feel confident counseling a patient about PrEP” and “I would feel confident educating a colleague about PrEP” (Fig. 2). Both confidence items were evaluated using the same 7-point Likert scale.

F1
Figure 1:
Across the 6 knowledge items, future pharmacists represented a higher percentage of students who selected the most accurate answers. Those items above the dotted line were items that were considered true, making the most accurate answer “completely/strongly agree,” and those below were considered false, making the most accurate answer “completely/strongly disagree.”
F2
Figure 2:
Students' confidence regarding counseling a patient about PrEP or educating a colleague about PrEP. In response to both items, nearly half of the sample reported feeling less confident in their abilities related to these tasks.

Statistical Analysis

Descriptive statistics were computed to describe the sample. Respondents' professional programs were collapsed into future prescribers (allopathic medicine, osteopathic medicine, PA), future nurses, and future pharmacists. States were collapsed into regions (South, Northeast, West, Midwest) based on US Census Bureau divisions.1

Pearson χ2 tests were used to compare awareness of PrEP and PrEP education across student professional groups and across years of training. Four of the 7 knowledge items were reverse scored (1 = 7) such that higher scores on all items indicated more accurate knowledge. Response options were then recoded: 5, 6, and 7 were collapsed into “correct” (1), and all remaining responses (1–4) were coded as “incorrect” (0).

The total number of correct knowledge items was summed to create an aggregate knowledge score (range, 0–6). Aggregate knowledge scores were then dichotomized. Students scoring either a 5 or 6 on the aggregate knowledge scale were classified as having “high knowledge” (1), and those with a lower score (0–4) were classified as having low knowledge (0). A similar recoding process was used for the 2 confidence items, again with the end of the Likert scale collapsed such that 5, 6, and 7 were indicative of high confidence (1) and all other responses (1–4) were coded as low confidence (0). Pearson χ2 tests were used to examine demographic differences in the percentage of students with high versus low knowledge and high versus low confidence. χ2 Tests were also used to examine the relationship between knowledge and confidence.

All analyses were conducted using IBM SPSS v25.0 (Armonk, NY). Statistical significance was established as P < 0.05. This study was granted exempt status by the institutional review board of Rosalind Franklin University (Protocol No. COP-18-132).

RESULTS

The survey was initiated by 2571 students, with 2085 completing it entirely (n = 2085). The overall response rate was 2.4%, representing a diverse sample of health professional students. Because of the distribution methodology, individual response rates were calculated for each profession included in this study (Table 1). National demographic information describing students in the 5 programs included in this study is provided in Appendix 2, https://links.lww.com/OLQ/A541%20 for comparison to the study sample, as is a list of the professional societies from which respondents were recruited.

TABLE 1 - Demographics of Survey Respondents (n = 2085)
Complete Sample Future Prescribers Future Nurses Future Pharmacists
Allopathic Medicine Osteopathic Medicine Physician Assistant
n %* n %* n %* n %* n %* n %*
Total 2085 100 591 28.3 316 15.2 144 6.9 741 35.5 293 14.1
M SD M SD M SD M SD M SD M SD
Age 28.0 8.0 26.3 5.3 27.4 6.6 29.5 8.3 30.5 10.1 25.2 5.1
n % n % n % n % n % n %
Gender
 Male 499 23.9 211 35.7 109 34.5 29 20.1 92 12.4 58 19.8
 Female 1557 74.7 366 61.9 203 64.2 114 79.2 641 86.5 233 79.5
 Transgender/Other 29 1.4 14 2.4 4 1.3 1 0.7 8 1.1 2 0.7
Sexual orientation
 Heterosexual 1675 80.3 455 77.0 246 77.8 127 88.2 607 81.9 240 81.9
 Gay 181 8.7 66 11.2 29 9.2 6 4.2 48 6.5 32 10.9
 Bisexual 161 7.7 48 8.1 26 8.2% 9 6.3 67 9.0 11 3.8
 Other 68 3.3 22 3.7 15 4.7 2 1.4 19 2.6 10 3.4
Year in training
 1st year 436 20.9 161 27.2 105 33.2 49 34.0 86 11.6 35 11.9
 2nd year 636 30.5 149 25.2 117 37.0 80 55.6 216 29.1 74 25.3
 3rd year 427 20.5 136 23.0 55 17.4 11 7.6 135 18.2 90 30.7
 4th year and up 586 28.1 145 24.5 39 12.3 4 2.8 304 41.0 94 32.1
Race
 African American (Black) 163 7.8 67 11.3 11 3.5 7 4.9 55 7.4 23 7.8
 Caucasian (White) 1388 66.6 350 59.2 211 66.8 108 75.0 516 69.6 203 69.3
 Hispanic/Latinx 152 7.3 30 5.1 15 4.7 8 5.6 83 11.2 16 5.5
 Native American 18 0.9 3 0.5 1 0.3 3 2.1 10 1.3 1 0.3
 Asian 259 12.4 102 17.3 59 18.7 9 6.3 45 6.1 44 15.0
 Other 105 5.0 39 6.6 19 6.0 9 6.3 32 4.3 6 2.0
Region
 South 733 35.2 165 27.9 120 38.0 66 45.8 264 35.6 118 40.3
 Northeast 336 16.1 82 13.9 32 10.1 22 15.3 153 20.6 47 16.0
 West 416 20.0 101 17.1 88 27.8 18 12.5 179 24.2 30 10.2
 Midwest 600 28.8 243 41.1 76 24.1 38 26.4 145 19.6 98 33.4
*Row percentage.
Column percentage.

Demographics

The demographics of survey respondent are summarized in Table 1. The mean (SD) age of the respondents was 28.0 (8.0) years. A majority of respondents were female (n = 1557; 74.7%), heterosexual (n = 1675; 80.3%), and White (n = 1388; 66.6%). Regionally, the largest group of respondents was training in the Southern United States (n = 733; 35.2%). Finally, the largest group of respondents was in the second year of their respective academic programs (n = 636; 30.5%), and approximately half were future prescribers (n = 1051; 50.4%).

Awareness of PrEP

Considering the entire sample, 1701 (81.6%) students indicated that they were aware of PrEP. Awareness varied by students' professional program, with the highest percentage of future pharmacists reporting awareness of PrEP (92.2%) as compared with nurses and prescribers (67.5% [χ12 = 67.2, P < 0.001] and 88.6% [χ12 = 3.07, P = 0.08], respectively). Second-year (85.3%, χ12 = 19.7, P < 0.001), third-year (85.0%, χ12 = 20.9, P < 0.001), and fourth-year (84.0%, χ12 = 20.6, P < 0.001) students reported higher awareness than did first-year students (72.2%), but did not differ significantly from each other.

Overall, 45.4% (n = 947) of students indicated receiving education about PrEP in their academic program. The percentage of future pharmacists taught about PrEP (71.0%) was higher than that of future nurses (40.3%, χ12 = 78.9, P < 0.001) and future prescribers (60.0%, χ12 = 11.7, P = 0.001), whereas the percentage of future prescribers was greater than that of future nurses (χ12 = 67.5, P < 0.001). Only those students who indicated they were aware of PrEP (n = 1701) were included in the subsequent analyses of knowledge and confidence.

Knowledge About PrEP

Overall, responses to the individual knowledge items were mixed (Fig. 1). When drawing comparisons across all items to identify specific areas of knowledge deficiency, all student groups reported the least accurate knowledge in response to whether using PrEP has resulted in widespread HIV resistance to TDF/FTC. For most items, future nurses reported the least accurate knowledge as compared with future pharmacists and prescribers. Overall, 71.0% of students scored in the high knowledge range (n = 1208), including 80.0% of future pharmacists, 78.2% of future prescribers, and 52.8% of future nurses (Table 2). Only the pairwise comparison between future pharmacists and future nurses was statistically significant (χ12 = 47.5, P < 0.001).

TABLE 2 - Bivariate Comparisons of the Percentage of Students With High Knowledge, High Confidence Counseling a Patient, and High Confidence Educating a Colleague About PrEP
High Knowledge About PrEP Confidence Counseling a Patient About PrEP Confidence Educating a Colleague About PrEP
%* P %* P %* P
<0.001 0.002 0.02
Academic program
 Future pharmacist 80.0 Ref. 73.0 Ref. 77.0 Ref.
 Future prescribers 78.2 0.70 61.9 0.001 71.4 0.07
 Future nurses 52.8 <0.001 67.6 0.12 77.8 0.81
Sexual orientation <0.001 <0.001 <0.001
 Heterosexual (straight) 68.7 Ref. 60.8 Ref. 71.5 Ref.
 Homosexual (gay) 84.5 <0.001 84.5 <0.001 86.2 <0.001
 Bisexual 73.9 0.09 78.2 <0.001 82.4 0.006
 Other 75.0 0.67 76.8 0.02 78.6 0.25
Year in training 0.01 0.74 0.50
 1st year 71.6 Ref. 61.4 Ref. 73.7 Ref.
 2nd year 68.6 0.42 64.4 0.94 74.4 0.81
 3rd year 77.7 0.06 65.0 0.81 71.6 0.56
 4th year and up 68.3 0.43 67.3 0.36 76.2 0.41
Race/Ethnicity 0.001 0.08 0.12
 Caucasian (White) 74.5 Ref. 66.3 Ref. 74.9 Ref.
 African American (Black) 63.7 0.009 65.1 0.77 69.9 0.19
 Hispanic/Latinx 62.7 0.004 72.0 0.21 82.2 0.08
 Native American 54.6 0.18 45.5 0.15 63.6 0.39
 Asian 66.2 0.02 61.4 0.17 72.0 0.37
 Other 62.7 0.03 55.4 0.04 67.5 0.13
Region 0.08 0.37 0.81
 South 69.9 Ref. 66.3 Ref. 75.5 Ref.
 Northeast 66.2 0.39 64.7 0.63 72.9 0.41
 West 74.4 0.08 61.4 0.13 73.2 0.44
 Midwest 72.8 0.19 67.0 0.82 74.0 0.57
Gender 0.04 <0.001 0.006
 Male 75.2 Ref. 73.8 Ref. 80.0 Ref.
 Female 69.6 0.01 62.3 <0.001 72.2 0.001
 Transgender/other 66.7 0.21 66.7 0.44 70.8 0.28
PrEP education (Ref. = no) 73.6 0.003 56.8 0.50 57.0 0.40
Knowledge score (Ref. = low) 66.9 <0.001 66.4 <0.001
Bold indicates statistically significant.
All P values in the header represent the omnibus χ2 comparison, and subsequent P values represent pairwise comparisons to the identified reference category.
*The percentage of each group which had either high knowledge or high confidence.

We found that students identifying as homosexual were more likely to demonstrate high knowledge (84.5%) compared with heterosexual students (66.9%; χ12 = 20.4, P < 0.001). A greater percentage of White students demonstrated high knowledge (74.5%) as compared with those identifying as African American (63.7%; χ12 = 6.85, P = 0.009), Latinx (62.7%;χ12 = 8.26, P = 0.004), Asian (66.2%; χ12 = 5.47, P = 0.02), or another race (62.7%; χ12 = 4.86, P = 0.03). A greater percentage of male students demonstrated high knowledge (75.2%) as compared with female students (69.6; χ12 = 5.98, P = 0.01). Finally, a greater percentage of students who reported learning about PrEP in their academic program demonstrated high knowledge (71.7%) as compared with students who did not (64.6%; χ12 = 9.13, P = 0.003).

Confidence

Overall, 65.3% (n = 1111) of students reported high confidence counseling a patient about PrEP, including 73.0% of future pharmacists, 61.9% of future prescribers, and 67.6% of future nurses (Table 2). Only the pairwise comparison between future pharmacists and future prescribers was significant (χ12 = 11.2, P = 0.001). High confidence was reported by a greater percentage of students who identified as homosexual (84.5%; χ12 = 38.7, P < 0.001), bisexual (78.2%; χ12 = 16.5, P < 0.001), or some other sexual orientation (76.8%; χ12 = 5.78, P = 0.02) as compared with heterosexual students (60.8%). A greater percentage of male students reported high confidence (73.8%) relative to female students (62.3%; χ12 = 19.0, P < 0.001). A greater percentage of students who demonstrated high knowledge of PrEP reported high confidence counseling a patient about PrEP (70.6%) as compared with students demonstrating low knowledge (53.4%; χ12 = 46.8, P < 0.001). There were no significant differences in confidence counseling patients based on race or prior PrEP education.

In the complete sample, 74.2% (n = 1262) reported high confidence educating a colleague about PrEP, representing 71.4% of future prescribers, 77.8% of future nurses, and 77.0% of future pharmacists (Table 2). There was no significant difference between the profession groups in confidence educating a colleague about PrEP. A similar trend to that seen with confidence counseling a patient was found for confidence educating a colleague about PrEP with respect to students' sexual orientation: high confidence reported by a greater percentage of students who identified as homosexual (86.2%; χ12 = 17.6, P < 0.001) and bisexual (82.4%; χ12 = 7.67, P = 0.006) as compared with heterosexual students (71.5%). A higher percentage of male students had high confidence educating a colleague about PrEP (80.0%) compared with female students (72.2%; χ12 = 10.2, P = 0.001). A greater percentage of students who demonstrated high knowledge of PrEP reported high confidence educating a colleague about PrEP (78.4%) as compared with students demonstrating low knowledge (64.8%; χ12 = 35.1, P < 0.001). Finally, there was no significant difference in confidence educating a colleague about PrEP based on whether a student received education about PrEP in their academic program or students’ race. Confidence counseling a patient was positively correlated with confidence educating a colleague about PrEP (r = 0.70, P < 0.001).

DISCUSSION

Overall, this study illuminates significant variability in the awareness, education, knowledge, and confidence of future prescribers, nurses, and pharmacists regarding PrEP for HIV prevention. Future pharmacists were more likely to have received formal education about PrEP, which is aligned with our previous findings, and were more likely to report high knowledge of PrEP as compared with future nurses and prescribers.32s We also found that higher knowledge was associated with more confidence counseling patients about PrEP and educating colleagues about PrEP, and that higher knowledge of PrEP was associated with having received training about PrEP in one's coursework.

Preexposure prophylaxis is and will be an integral part of HIV prevention efforts, as specified by the US President's Plan to End the HIV Epidemic.39s We found that an encouraging percentage of health profession students were aware of PrEP (81.6%), which is higher than previously reported percentages of practicing clinicians.13,14,16–28 The results of this study extend the findings of previous, smaller-scale studies that found deficiencies in health profession students' knowledge and decision making regarding PrEP.40s–44s The gaps in awareness, education, knowledge, and confidence of future health professionals present barriers to future HIV prevention efforts using PrEP.

The prevention and treatment of HIV requires interprofessional collaboration between prescribers, nurses, and pharmacists.45s–49s Consequently, it is imperative that the curricula of all health professional disciplines, including those surveyed here, address the role of PrEP in HIV prevention. Curricula must also address health profession students' role on a health care team with respect to prescription and subsequent management of patients taking PrEP. The data presented here suggest that there are curricular gaps in the programs of students who may become part of interprofessional health care teams caring for patients at risk for HIV once they are licensed professionals. Closing these knowledge gaps is critical, especially when considering that previous studies of health care providers have shown that increased knowledge of PrEP is associated with higher rates of prescription to patients at risk for HIV.16s,50s

Pharmacists are increasingly important providers when considering prescription of PrEP.51s–54s Multiple protocols for pharmacist-led PrEP initiatives have been reported, and California recently passed legislation that allows pharmacists to prescribe up to a 60-day supply of PrEP without a physician prescription.52s,55s–58s Furthermore, on-demand PrEP protocols, which are reliant on pharmacist management, have demonstrated success.59s Implementation of these protocols requires training of pharmacists to recognize patients at risk for HIV, and then engage in counseling about PrEP.60s,61s The overall high awareness, knowledge, and confidence among the future pharmacists in this sample suggest that training using these pharmacist-led models of PrEP delivery is becoming a facet of pharmacy education and could be used to address gaps in curricula.

Furthermore, an increasing number of registered nurses and advanced practice nurses are becoming involved in the prescription and management of PrEP.62s–65s For example, same-day, nurse-led algorithmic PrEP initiation protocols are a promising development for scale up of PrEP.59s In anticipation of these growing roles, preparation of future nurses is essential. Approximately one-third of nursing students in their final year of training were unaware of PrEP. Future nurses also reported the least accurate responses to all knowledge items. This is in contrast with the high confidence reported by future nurses in this study. These results suggest that nursing education is preparing students with the skills to counsel patients but may be deficient in training on PrEP, and that current nursing students may be entering practice unprepared regarding HIV prevention using PrEP.

The future prescribers (medical and PA students) included in this study reported the lowest confidence in response to both items (patient counseling, educating a colleague), despite a higher likelihood of having high knowledge compared with the group with the highest confidence (future nurses). This low confidence is another potential barrier to increasing the use of PrEP, as these students are soon to enter their next phase of training and are expected to exhibit greater autonomy in patient care. Our findings suggest that medical and PA education may not be preparing students to counsel patients and educate colleagues about PrEP as primary HIV prevention. These findings also suggest that collaborative education between disciplines may be beneficial for curriculum development, specifically inclusion of pharmacy educators and pharmacists, owing to their higher knowledge scores. This collaboration in education for shared preparation of health care students may also be valuable for later roles once students reach practice. It is also essential for educators to identify places within current curricula where education about PrEP can be included or strengthened and to ensure that interprofessional collaboration as a key strategy for increasing PrEP prescriptions is included in education.

Regarding patient indications, we found an interesting discrepancy in students' knowledge of which patients are indicated for HIV prevention with PrEP. Students largely agreed that patients other than gay men were potential PrEP users, but reported less endorsement that PrEP could benefit TWSM and PWID for HIV prevention. This lack of knowledge regarding the HIV risk of TWSM and corresponding need for PrEP may be a result of an overall lack of training on transgender health care.66s,67s It may also be connected to low knowledge about sexual and gender minorities among practitioners who are likely to be the ones who are teaching students about PrEP.19,20,22,25–28 Previous work has also established gaps in training and knowledge regarding PWID among health profession students.68s–71s Ensuring adequate, accurate, and unbiased education about biomedical HIV prevention strategies like PrEP is one facet of strategies for reducing HIV among TWSM and PWID. Based on our results, health profession students, in general, may require more instruction on the full scope of patients at risk for HIV and who may benefit from protection from PrEP.

Correcting students' misunderstandings about PrEP with nuanced education is essential, and one such misunderstanding is the relationship of PrEP to HIV resistance. A large number of students lacked understanding that the use of PrEP is not linked to widespread HIV resistance to TDF/FTC. Although this is a theoretical concern, strong evidence has shown that TDF/FTC resistance is extremely rare and that the benefits of using PrEP outweigh this potential risk.33s,72s Ensuring this accurate understanding is conveyed to students during training is important for preparing health care professionals to enter practice with correct information to safely prescribe PrEP to patients at risk for HIV.

There are several limitations of the present study that should be considered when interpreting the findings. The first is the inherent limitation of cross-sectional data collection through a self-administered, anonymous survey. Selection and reporting biases are possible with this methodology, and the responses here may be overrepresentative of students who had an existing interest or experience with PrEP or HIV. In addition, causality cannot be inferred.

The survey response rates of this investigation are another limitation. Based on the national distribution methodology, which involved a very large group of potential respondents, the low response rates are expected. Furthermore, low response rate is a common problem of survey studies, especially those conducted at the national scale, and is also a well-established problem when surveying health care professionals on this topic.73s When comparing the national demographics of health professionals in training (Appendix 2, https://links.lww.com/OLQ/A541), we did largely achieve parity in terms of race between this sample and national student populations. Our sample contained slightly more female students than nationally, and sexual and gender minority students are also overrepresented in our sample (Appendix 2, https://links.lww.com/OLQ/A541). Comparison of all demographic details was difficult because not all national organizations publicly report data on the gender identity and sexual orientation of their trainees. Inclusion of only undergraduate nursing students is another sampling limitation, as it excludes advanced practice nurses who may be PrEP prescribers. However, we feel that it is important to evaluate knowledge at the undergraduate nursing level as a baseline assessment of nursing education and future nurses' knowledge and confidence regarding PrEP.

Finally, we acknowledge the need for more robust, detailed characterization of PrEP education content and format, including a more in-depth knowledge inventory. In addition to broadening content, the current inventory may be otherwise refined (e.g., by improving clarity of wording) and expanded, through consultation with health profession students. Future work would benefit from a systematic inventory of educational materials used to teach about PrEP in multiple academic programs and to determine the effects of those educational interventions on student knowledge of PrEP. Such an inventory may produce best-practice guidelines for educating a diverse group of health profession students about PrEP. The findings reported here, however, lay a foundation for further investigation and innovation of health professions curriculum about PrEP and HIV prevention.

This study explored the awareness, education, knowledge, and confidence in skills regarding PrEP in health profession students across the United States. Understanding the knowledge base of future health care providers is important, as they may be called upon to consider PrEP in patient care or to lead quality improvement, training, or program evaluation initiatives about HIV prevention with PrEP once they become licensed professionals. Results from this study indicate that, although most health profession students are aware of PrEP, more comprehensive education about PrEP is needed across health professions curricula. The Food and Drug Administration recently approved a second drug, emtricitabine/tenofovir alafenamide for use as PrEP, and PrEP prescriptions have increased each year since approval. Filling educational gaps about PrEP is necessary to give future health care professionals of all disciplines the skills to competently fulfill their professional roles, collaborate across disciplines, and ultimately contribute to better patient care by increasing access to PrEP for patients at risk for HIV.

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