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Current HIV Research

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ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

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Research Article

Perceptions on HIV Pre-Exposure Prophylaxis Among Urgent Care Clinicians in the Southern United States

Author(s): Charles M. Burns*, Kyle Endres, Laura Farrow, Carl Mhina, Alexandra Cooper, Benjamin Silverberg, Mehri S. McKellar and Nwora Lance Okeke

Volume 20, Issue 3, 2022

Published on: 13 May, 2022

Page: [204 - 212] Pages: 9

DOI: 10.2174/1570162X20666220426094920

open access plus

Abstract

Background: Underutilization of HIV pre-exposure prophylaxis (PrEP) in the Southern United States (US) is well-documented. Urgent care (UC) centers are positioned as communityfacing access points to PrEP, but the feasibility of integrating PrEP services into this setting is unclear. We conducted a survey of UC clinicians in the Southern US to better understand their perceptions of the feasibility of providing PrEP in their practice setting.

Objective: The study aims to determine the feasibility and acceptability of providing PrEP services in the UC setting through a cross-sectional survey of UC clinicians.

Methods: We conducted a 48-item cross-sectional survey of UC clinicians in the Southern US, between July and September 2020. The survey was distributed through the Urgent Care Association (UCA) and American Academy of Urgent Care Medicine (AAUCM) professional listservs as well as directly to publicly listed e-mail addresses.

Results: Eighty-two clinicians responded to the survey. Most clinicians had familiarity with PrEP (97%). All respondents rated PrEP as an effective way to prevent HIV. However, less than half felt UC facilities were an appropriate place to prescribe PrEP. Few respondents (8%) expressed doubts that expansion of PrEP access would decrease the incidence of HIV in their community.

Conclusion: These findings show UC clinicians are familiar with PrEP, and many believe it would benefit their patients; however, provider opinions on the appropriateness of providing PrEP in the UC setting differ. Further studies on PrEP implementation in UC centers are needed.

Keywords: HIV pre-exposure prophylaxis, PrEP, urgent care, survey, southern United States, sexually transmitted infections.

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Graphical Abstract

[1]
Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med 2012; 367(5): 399-410.
[http://dx.doi.org/10.1056/NEJMoa1108524] [PMID: 22784037]
[2]
Mayer KH, Krakower DS. Editorial commentary: Scaling up antiretroviral preexposure prophylaxis: Moving from trials to implementation. Clin Infect Dis 2015; 61(10): 1598-600.
[http://dx.doi.org/10.1093/cid/civ665] [PMID: 26270688]
[3]
Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med 2010; 363(27): 2587-99.
[http://dx.doi.org/10.1056/NEJMoa1011205] [PMID: 21091279]
[4]
Grant RM, Anderson PL, McMahan V, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: A cohort study. Lancet Infect Dis 2014; 14(9): 820-9.
[http://dx.doi.org/10.1016/S1473-3099(14)70847-3] [PMID: 25065857]
[5]
Smith DK, Van Handel M, Wolitski RJ, et al. Vital signs: Estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition--United States, 2015. MMWR Morb Mortal Wkly Rep 2015; 64(46): 1291-5.
[http://dx.doi.org/10.15585/mmwr.mm6446a4] [PMID: 26606148]
[6]
CDC. Diagnosis of HIV infection in the united states and dependent areas, 2017. HIV Surveillance Report, 2018; 29 Available from: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf Accessed on May 12 2019.
[7]
CDC. HIV and youth. 2021. Available from: https://www.cdc. gov/hiv/group/age/youth/index.html Accessed on February 19 2021.
[8]
NC-Healthcare. Five ways tech-savvy millenials alter health care landscape 2015. Available from: https://www.prnewswire. com/news-releases/five-ways-tech-savvy-millennials-alter-health-care-landscape-300054028.html Accessed on March 9, 2019.
[9]
Burns DN, Grossman C, Turpin J, Elharrar V, Veronese F. Role of oral pre-exposure prophylaxis (PrEP) in current and future HIV pre-vention strategies. Curr HIV/AIDS Rep 2014; 11(4): 393-403.
[http://dx.doi.org/10.1007/s11904-014-0234-8] [PMID: 25283184]
[10]
Mayer KH, Chan PAR, Patel R, Flash CA, Krakower DS. Evolving models and ongoing challenges for HIV preexposure prophylaxis im-plementation in the United States. J Acquir Immune Defic Syndr 2018; 77(2): 119-27.
[http://dx.doi.org/10.1097/QAI.0000000000001579] [PMID: 29084044]
[11]
Zhang HL, Rhea SK, Hurt CB, et al. HIV preexposure prophylaxis implementation at local health departments: A statewide assessment of activities and barriers. J Acquir Immune Defic Syndr 2018; 77(1): 72-7.
[http://dx.doi.org/10.1097/QAI.0000000000001546] [PMID: 28902704]
[12]
Ng YC, Caires A, Mayeux J. Message from an urgent care PrEP provider for health care professionals. J Assoc Nurses AIDS Care: JANAC 2018; 29(1): 130-2.
[http://dx.doi.org/10.1016/j.jana.2017.09.010] [PMID: 29032926]
[13]
Ayers AA. Is PrEP appropriate for urgent care? 2018. Available from: https://wwwjucmcom/is-prep-appropriate-for-urgent-care/ Accessed March 3 2021.
[14]
Haukoos JS, White DAE, Rowan SE, et al. HIV risk and pre-exposure prophylaxis eligibility among emergency department patients. AIDS Patient Care STDS 2021; 35(6): 211-9.
[http://dx.doi.org/10.1089/apc.2021.0012] [PMID: 34097464]
[15]
Ridgway JP, Friedman EE, Bender A, et al. Evaluation of an electronic algorithm for identifying cisgender female pre-exposure prophylax-is candidates. AIDS Patient Care STDS 2021; 35(1): 5-8.
[http://dx.doi.org/10.1089/apc.2020.0231] [PMID: 33400588]
[16]
Ridgway JP, Almirol EA, Bender A, et al. Which patients in the emergency department should receive preexposure prophylaxis? imple-mentation of a predictive analytics approach. AIDS Patient Care STDS 2018; 32(5): 202-7.
[http://dx.doi.org/10.1089/apc.2018.0011] [PMID: 29672136]
[17]
Ayers AA. New lawsuits re-examine prescribing of PrEP in urgent care. JUCM 2020.
[18]
CDC. Preexposure prophylaxis for the prevention of HIV infection in the United States - 2021 update: A clinical practice guideline. 2021. Available from: https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf
[19]
Traeger MW, Cornelisse VJ, Asselin J, et al. Association of HIV preexposure prophylaxis with incidence of sexually transmitted infec-tions among individuals at high risk of HIV infection. JAMA 2019; 321(14): 1380-90.
[http://dx.doi.org/10.1001/jama.2019.2947] [PMID: 30964528]
[20]
Ong JJ, Baggaley RC, Wi TE, et al. Global epidemiologic characteristics of sexually transmitted infections among individuals using preex-posure prophylaxis for the prevention of HIV infection: A systematic review and meta-analysis. JAMA Netw Open 2019; 2(12): e1917134.
[http://dx.doi.org/10.1001/jamanetworkopen.2019.17134] [PMID: 31825501]
[21]
Clement ME, Seidelman J, Wu J, et al. An educational initiative in response to identified PrEP prescribing needs among PCPs in the South-ern U.S. AIDS Care 2018; 30(5): 650-5.
[http://dx.doi.org/10.1080/09540121.2017.1384534] [PMID: 28971705]
[22]
Mayeux JJ, Ng YC, Bice MM. Outcomes from an urgent care pre-exposure prophylaxis protocol for the prevention of HIV. J Assoc Nurses AIDS Care: JANAC 2020; 31(6): 678-84.
[http://dx.doi.org/10.1097/JNC.0000000000000178] [PMID: 32427648]
[23]
U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. Sex, Race, and Ethnic Diversity of US, Health Occupations (2011-2015). Rockville, Maryland 2017.
[24]
CDC. Statistics overview - new HIV diagnoses among adults and adolescents in the US and dependent areas by race/ethnicity. 2021. Available from: https://www.cdc.gov/hiv/statistics/overview/index.html Accessed on June 24, 2021.
[25]
AAPOR. Response rates - an overview. 2021. Available from: https://www.aapor.org/Education-Resources/For-Researchers/Poll-Survey-FAQ/Response-Rates-An-Overview.aspx Accessed on February 19 2021.
[26]
Wiebe ER, Kaczorowski J, MacKay J. Why are response rates in clinician surveys declining? Can Fam Physician 2012; 58(4): e225-8.
[PMID: 22611609]
[27]
Cunningham CT, Quan H, Hemmelgarn B, et al. Exploring physician specialist response rates to web-based surveys. BMC Med Res Methodol 2015; 15: 32.
[http://dx.doi.org/10.1186/s12874-015-0016-z] [PMID: 25888346]
[28]
Adams LM, Balderson BH. HIV providers’ likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: A short report. AIDS Care 2016; 28(9): 1154-8.
[PMID: 26915281]
[29]
Krakower DS, Oldenburg CE, Mitty JA, et al. Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention: Results from a survey of healthcare providers in new England. PLoS One 2015; 10(7): e0132398.
[http://dx.doi.org/10.1371/journal.pone.0132398] [PMID: 26146824]
[30]
Tellalian D, Maznavi K, Bredeek UF, Hardy WD. Pre-exposure prophylaxis (PrEP) for HIV infection: Results of a survey of HIV healthcare providers evaluating their knowledge, attitudes, and prescribing practices. AIDS Patient Care STDS 2013; 27(10): 553-9.
[http://dx.doi.org/10.1089/apc.2013.0173] [PMID: 24053478]
[31]
Silverman TB, Schrimshaw EW, Franks J, et al. Response Rates of medical providers to internet surveys regarding their adoption of preexposure prophylaxis for HIV: Methodological implications. J Int Assoc Provid AIDS Care 2018; 17: 2325958218798373.
[http://dx.doi.org/10.1177/2325958218798373] [PMID: 30226090]

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