Objectives
The
Centers for Disease Control and Prevention defines HIV prevention as a core family
planning service. The HIV community identified family planning visits as key
encounters for women to access pre-exposure prophylaxis (PrEP) for HIV
prevention. No studies explore United States family planning providers’
knowledge of and attitudes towards PrEP. We conducted a national survey of
clinicians to understand barriers and facilitators to PrEP implementation in
family planning.
Study Design
Family
planning providers recruited via website postings, national meetings, and email
completed an anonymous survey in 2015. Descriptive statistics were performed.
Results
Among
604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers
(physicians, nurse practitioners, midwives, or physicians assistants). Among
potential prescribers, 38% correctly defined PrEP (95% CI 32.5 – 42.8), 37%
correctly stated the efficacy of PrEP (95% CI 32.0 – 42.4), and 36% chose the
correct HIV test after a recent exposure (95% CI 30.6 – 40.8). Characteristics
of those who answered knowledge questions correctly included age less than 35,
practicing in the Northeast or West, routinely offering HIV testing, providing
rectal sexually transmitted infection screening, or having seen any PrEP
guidelines. Even among providers in the Northeast and West, the proportion of
respondents answering questions correctly was less than 50%. Thirty-six percent
of respondents had seen any PrEP guidelines. Providers identified lack of
training as the main barrier to PrEP implementation; 87% wanted PrEP education.
Conclusions
To
offer comprehensive HIV prevention services, family planning providers urgently
need training on PrEP and HIV testing.
Implications
U.S.
family planning providers have limited knowledge about HIV pre-exposure
prophylaxis (PrEP) and HIV testing, and report lack of provider training as the
main barrier to PrEP provision. Provider education is needed to ensure family
planning clients access comprehensive HIV prevention methods.
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