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- Title
Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training.
- Authors
Cooper, Robert L.; Juarez, Paul D.; Morris, Matthew C.; Ramesh, Aramandla; Edgerton, Ryan; Brown, Lauren L.; Mena, Leandro; MacMaster, Samuel A.; Collins, Shavonne; Juarez, Patricia Matthews-; Tabatabai, Mohammad; Brown, Katherine Y.; Paul, Michael J.; Im, Wansoo; Arcury, Thomas A.; Shinn, Marybeth
- Abstract
There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision. Four overarching barriers presented in the literature: Purview Paradox, Patient Financial Constraints, Risk Compensation, and Concern for ART Resistance. Considering the physician-identified barriers, we make recommendations for how physicians and students may work to increase PrEP knowledge and competence along each stage of the PrEP cascade. We recommend adopting HIV risk assessment as a standard of care, improving physician ability to identify PrEP candidates, improving physician interest and ability in encouraging PrEP uptake, and increasing utilization of continuous care management to ensure retention and adherence to PrEP.
- Subjects
HIV prevention; HIV infection risk factors; MEDICAL quality control; ONLINE information services; CINAHL database; PSYCHOLOGY information storage &; retrieval systems; PROFESSIONS; MEDICAL students; SYSTEMATIC reviews; MEDICAL care; PHYSICIANS' attitudes; ANTIRETROVIRAL agents; DRUG resistance; MEDICAL screening; CURRICULUM; INCOME; HEALTH insurance reimbursement; RISK assessment; ABILITY; CONTINUUM of care; MEDICAL care use; RESEARCH funding; DRUG prescribing; CLINICAL competence; INTERPROFESSIONAL relations; PREVENTIVE medicine; LITERATURE reviews; PHYSICIAN practice patterns; PATIENT compliance; MEDLINE; HEALTH promotion; MEDICAL education
- Publication
Inquiry (00469580), 2021, p1
- ISSN
0046-9580
- Publication type
Article
- DOI
10.1177/00469580211017666