Skip to main content
Top
Published in: AIDS and Behavior 4/2017

01-04-2017 | Original Paper

Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs

Authors: E. Jennifer Edelman, Brent A. Moore, Sarah K. Calabrese, Gail Berkenblit, Chinazo Cunningham, Viraj Patel, Karran Phillips, Jeanette M. Tetrault, Minesh Shah, David A. Fiellin, Oni Blackstock

Published in: AIDS and Behavior | Issue 4/2017

Login to get access

Abstract

Pre-exposure prophylaxis for HIV (PrEP) is recommended for people who inject drugs (PWID). Despite their central role in disease prevention, willingness to prescribe PrEP to PWID among primary care physicians (PCPs) is largely understudied. We conducted an online survey (April–May 2015) of members of a society for academic general internists regarding PrEP. Among 250 respondents, 74% (n = 185) of PCPs reported high willingness to prescribe PrEP to PWID. PCPs were more likely to report high willingness to prescribe PrEP to all other HIV risk groups (p’s < 0.03 for all pair comparisons). Compared with PCPs delivering care to more HIV-infected clinic patients, PCPs delivering care to fewer HIV-infected patients were more likely to report low willingness to prescribe PrEP to PWID (Odds Ratio [95% CI] = 6.38 [1.48–27.47]). PCP and practice characteristics were not otherwise associated with low willingness to prescribe PrEP to PWID. Interventions to improve PCPs’ willingness to prescribe PrEP to PWID are needed.
Literature
1.
go back to reference Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008;372(9651):1733–45.CrossRefPubMed Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008;372(9651):1733–45.CrossRefPubMed
2.
go back to reference Strathdee SA, Stockman JK. Epidemiology of HIV among injecting and non-injecting drug users: current trends and implications for interventions. Curr HIV/AIDS Rep. 2010;7(2):99–106.CrossRefPubMedPubMedCentral Strathdee SA, Stockman JK. Epidemiology of HIV among injecting and non-injecting drug users: current trends and implications for interventions. Curr HIV/AIDS Rep. 2010;7(2):99–106.CrossRefPubMedPubMedCentral
3.
go back to reference Centers for Disease Control and Prevention. Estimated HIV incidence in the United States, 2007–2010. 2012, Dec 2012 Report No. Centers for Disease Control and Prevention. Estimated HIV incidence in the United States, 2007–2010. 2012, Dec 2012 Report No.
4.
go back to reference MacArthur GJ, van Velzen E, Palmateer N, Kimber J, Pharris A, Hope V, et al. Interventions to prevent HIV and hepatitis C in people who inject drugs: a review of reviews to assess evidence of effectiveness. Int J Drug Policy. 2014;25(1):34–52.CrossRefPubMed MacArthur GJ, van Velzen E, Palmateer N, Kimber J, Pharris A, Hope V, et al. Interventions to prevent HIV and hepatitis C in people who inject drugs: a review of reviews to assess evidence of effectiveness. Int J Drug Policy. 2014;25(1):34–52.CrossRefPubMed
6.
go back to reference Des Jarlais DC, Kerr T, Carrieri P, Feelemyer J, Arasteh K. HIV infection among persons who inject drugs: ending old epidemics and addressing new outbreaks. AIDS. 2016;30(6):815–26.CrossRefPubMed Des Jarlais DC, Kerr T, Carrieri P, Feelemyer J, Arasteh K. HIV infection among persons who inject drugs: ending old epidemics and addressing new outbreaks. AIDS. 2016;30(6):815–26.CrossRefPubMed
7.
go back to reference WHO, UNODC, UNAIDS Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. 2012 Revision WHO, UNODC, UNAIDS Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. 2012 Revision
8.
go back to reference Escudero DJ, Lurie MN, Kerr T, Howe CJ, Marshall BD. HIV pre-exposure prophylaxis for people who inject drugs: a review of current results and an agenda for future research. J Int AIDS Soc. 2014;17:18899.CrossRefPubMedPubMedCentral Escudero DJ, Lurie MN, Kerr T, Howe CJ, Marshall BD. HIV pre-exposure prophylaxis for people who inject drugs: a review of current results and an agenda for future research. J Int AIDS Soc. 2014;17:18899.CrossRefPubMedPubMedCentral
9.
go back to reference Choopanya K, Martin M, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381(9883):2083–90.CrossRefPubMed Choopanya K, Martin M, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381(9883):2083–90.CrossRefPubMed
10.
go back to reference Martin M, Vanichseni S, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. The impact of adherence to preexposure prophylaxis on the risk of HIV infection among people who inject drugs. AIDS. 2015;29(7):819–24.CrossRefPubMed Martin M, Vanichseni S, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. The impact of adherence to preexposure prophylaxis on the risk of HIV infection among people who inject drugs. AIDS. 2015;29(7):819–24.CrossRefPubMed
11.
go back to reference US Public Health Service. Preexposure prophylaxis for the prevention of HIV infection in the United States—2014: A clinical practice guideline. 2014. US Public Health Service. Preexposure prophylaxis for the prevention of HIV infection in the United States—2014: A clinical practice guideline. 2014.
12.
go back to reference Loughlin A, Metsch L, Gardner L, Anderson-Mahoney P, Barrigan M, Strathdee S. Provider barriers to prescribing HAART to medically-eligible HIV-infected drug users. AIDS Care. 2004;16(4):485–500.CrossRefPubMed Loughlin A, Metsch L, Gardner L, Anderson-Mahoney P, Barrigan M, Strathdee S. Provider barriers to prescribing HAART to medically-eligible HIV-infected drug users. AIDS Care. 2004;16(4):485–500.CrossRefPubMed
13.
go back to reference Smith DK, Van Handel M, Wolitski RJ, Stryker JE, Hall HI, Prejean J, 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.CrossRefPubMed Smith DK, Van Handel M, Wolitski RJ, Stryker JE, Hall HI, Prejean J, 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.CrossRefPubMed
14.
go back to reference Underhill K, Operario D, Mimiaga MJ, Skeer MR, Mayer KH. Implementation science of pre-exposure prophylaxis: preparing for public use. Curr HIV/AIDS Rep. 2010;7(4):210–9.CrossRefPubMedPubMedCentral Underhill K, Operario D, Mimiaga MJ, Skeer MR, Mayer KH. Implementation science of pre-exposure prophylaxis: preparing for public use. Curr HIV/AIDS Rep. 2010;7(4):210–9.CrossRefPubMedPubMedCentral
16.
go back to reference Escudero DJ, Kerr T, Wood E, Nguyen P, Lurie MN, Sued O, et al. Acceptability of HIV pre-exposure prophylaxis (PREP) among people who inject drugs (PWID) in a canadian setting. AIDS Behav. 2015;19(5):752–7.CrossRefPubMedPubMedCentral Escudero DJ, Kerr T, Wood E, Nguyen P, Lurie MN, Sued O, et al. Acceptability of HIV pre-exposure prophylaxis (PREP) among people who inject drugs (PWID) in a canadian setting. AIDS Behav. 2015;19(5):752–7.CrossRefPubMedPubMedCentral
17.
go back to reference Krakower DS, Beekmann SE, Polgreen PM, Mayer KH. Diffusion of newer HIV prevention innovations: variable practices of frontline infectious diseases physicians. Clin Infect Dis. 2016;62(1):99–105.CrossRefPubMed Krakower DS, Beekmann SE, Polgreen PM, Mayer KH. Diffusion of newer HIV prevention innovations: variable practices of frontline infectious diseases physicians. Clin Infect Dis. 2016;62(1):99–105.CrossRefPubMed
18.
go back to reference Castel AD, Feaster DJ, Tang W, Willis S, Jordan H, Villamizar K, et al. Understanding HIV care provider attitudes regarding intentions to prescribe PrEP. J Acquir Immune Defic Syndr. 2015;70(5):520–8.CrossRefPubMedPubMedCentral Castel AD, Feaster DJ, Tang W, Willis S, Jordan H, Villamizar K, et al. Understanding HIV care provider attitudes regarding intentions to prescribe PrEP. J Acquir Immune Defic Syndr. 2015;70(5):520–8.CrossRefPubMedPubMedCentral
19.
go back to reference 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):1–5.CrossRef 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):1–5.CrossRef
21.
go back to reference Artenie AA, Jutras-Aswad D, Roy E, Zang G, Bamvita JM, Levesque A, et al. Visits to primary care physicians among persons who inject drugs at high risk of hepatitis C virus infection: room for improvement. J Viral Hepat. 2015;22(10):792–9.CrossRefPubMed Artenie AA, Jutras-Aswad D, Roy E, Zang G, Bamvita JM, Levesque A, et al. Visits to primary care physicians among persons who inject drugs at high risk of hepatitis C virus infection: room for improvement. J Viral Hepat. 2015;22(10):792–9.CrossRefPubMed
22.
go back to reference Krakower D, Ware N, Mitty JA, Maloney K, Mayer KH. HIV providers’ perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014;18(9):1712–21.CrossRefPubMedPubMedCentral Krakower D, Ware N, Mitty JA, Maloney K, Mayer KH. HIV providers’ perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014;18(9):1712–21.CrossRefPubMedPubMedCentral
23.
go back to reference Blackstock OJ, Moore BA, Berkenblit GV, Calabrese SK, Cunningham CO, Fiellin DA, et al. HIV Pre-exposure prophylaxis adoption among primary care physicians: implications for implementation. J Gen Intern Med. 2016. [Epub ahead of print]. Blackstock OJ, Moore BA, Berkenblit GV, Calabrese SK, Cunningham CO, Fiellin DA, et al. HIV Pre-exposure prophylaxis adoption among primary care physicians: implications for implementation. J Gen Intern Med. 2016. [Epub ahead of print].
24.
go back to reference Lum PJ, Little S, Botsko M, Hersh D, Thawley RE, Egan JE, et al. Opioid-prescribing practices and provider confidence recognizing opioid analgesic abuse in HIV primary care settings. J Acquir Immune Defic Syndr. 2011;56(Suppl 1):S91–7.CrossRefPubMed Lum PJ, Little S, Botsko M, Hersh D, Thawley RE, Egan JE, et al. Opioid-prescribing practices and provider confidence recognizing opioid analgesic abuse in HIV primary care settings. J Acquir Immune Defic Syndr. 2011;56(Suppl 1):S91–7.CrossRefPubMed
26.
go back to reference Westergaard RP, Ambrose BK, Mehta SH, Kirk GD. Provider and clinic-level correlates of deferring antiretroviral therapy for people who inject drugs: a survey of North American HIV providers. J Int AIDS Soc. 2012;15(1):10.CrossRefPubMedPubMedCentral Westergaard RP, Ambrose BK, Mehta SH, Kirk GD. Provider and clinic-level correlates of deferring antiretroviral therapy for people who inject drugs: a survey of North American HIV providers. J Int AIDS Soc. 2012;15(1):10.CrossRefPubMedPubMedCentral
27.
go back to reference Bogart LM, Kelly JA, Catz SL, Sosman JM. Impact of medical and nonmedical factors on physician decision making for HIV/AIDS antiretroviral treatment. J Acquir Immune Defic Syndr. 2000;23(5):396–404.CrossRefPubMed Bogart LM, Kelly JA, Catz SL, Sosman JM. Impact of medical and nonmedical factors on physician decision making for HIV/AIDS antiretroviral treatment. J Acquir Immune Defic Syndr. 2000;23(5):396–404.CrossRefPubMed
28.
go back to reference Ding L, Landon BE, Wilson IB, Wong MD, Shapiro MF, Cleary PD. Predictors and consequences of negative physician attitudes toward HIV-infected injection drug users. Arch Intern Med. 2005;165(6):618–23.CrossRefPubMed Ding L, Landon BE, Wilson IB, Wong MD, Shapiro MF, Cleary PD. Predictors and consequences of negative physician attitudes toward HIV-infected injection drug users. Arch Intern Med. 2005;165(6):618–23.CrossRefPubMed
29.
go back to reference Baral SD, Stromdahl S, Beyrer C. The potential uses of preexposure prophylaxis for HIV prevention among people who inject drugs. Curr Opin HIV AIDS. 2012;7(6):563–8.CrossRefPubMed Baral SD, Stromdahl S, Beyrer C. The potential uses of preexposure prophylaxis for HIV prevention among people who inject drugs. Curr Opin HIV AIDS. 2012;7(6):563–8.CrossRefPubMed
30.
go back to reference Malta M, Magnanini MM, Strathdee SA, Bastos FI. Adherence to antiretroviral therapy among HIV-infected drug users: a meta-analysis. AIDS Behav. 2010;14(4):731–47.CrossRefPubMed Malta M, Magnanini MM, Strathdee SA, Bastos FI. Adherence to antiretroviral therapy among HIV-infected drug users: a meta-analysis. AIDS Behav. 2010;14(4):731–47.CrossRefPubMed
31.
go back to reference VanGeest JB, Johnson TP, Welch VL. Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof. 2007;30(4):303–21.CrossRefPubMed VanGeest JB, Johnson TP, Welch VL. Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof. 2007;30(4):303–21.CrossRefPubMed
32.
go back to reference Dykema J, Stevenson J, Day B, Sellers SL, Bonham VL. Effects of incentives and pre notification on response rates and costs in a national web survey of physicians. Eval Health Prof. 2011;34(4):434–47.CrossRefPubMedPubMedCentral Dykema J, Stevenson J, Day B, Sellers SL, Bonham VL. Effects of incentives and pre notification on response rates and costs in a national web survey of physicians. Eval Health Prof. 2011;34(4):434–47.CrossRefPubMedPubMedCentral
33.
go back to reference Klabunde CN, Willis GB, McLeod CC, Dillman DA, Johnson TP, Greene SM, et al. Improving the quality of surveys of physicians and medical groups: a research agenda. Eval Health Prof. 2012;35(4):477–506.CrossRefPubMed Klabunde CN, Willis GB, McLeod CC, Dillman DA, Johnson TP, Greene SM, et al. Improving the quality of surveys of physicians and medical groups: a research agenda. Eval Health Prof. 2012;35(4):477–506.CrossRefPubMed
34.
go back to reference Krakower DS, Oldenburg CE, Mitty JA, Wilson IB, Kurth AE, Maloney KM, 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.CrossRefPubMedPubMedCentral Krakower DS, Oldenburg CE, Mitty JA, Wilson IB, Kurth AE, Maloney KM, 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.CrossRefPubMedPubMedCentral
35.
go back to reference Mera RM, Palmer S, Mayer B, Magnuson G, RawlingsD, Truvada K (TVD) for HIV pre-exposure prophylaxis (PrEP) utilization in the United States (2013–2015). International AIDS Conference:Durban 2016. Mera RM, Palmer S, Mayer B, Magnuson G, RawlingsD, Truvada K (TVD) for HIV pre-exposure prophylaxis (PrEP) utilization in the United States (2013–2015). International AIDS Conference:Durban 2016.
36.
go back to reference Edelman EJ, Dinh AT, Moore BA, Schottenfeld RS, Fiellin DA, Sullivan LE. Human immunodeficiency virus testing practices among buprenorphine-prescribing physicians. J Addict Med. 2012;6(2):159–65.CrossRefPubMedPubMedCentral Edelman EJ, Dinh AT, Moore BA, Schottenfeld RS, Fiellin DA, Sullivan LE. Human immunodeficiency virus testing practices among buprenorphine-prescribing physicians. J Addict Med. 2012;6(2):159–65.CrossRefPubMedPubMedCentral
37.
go back to reference Underhill K, Morrow KM, Colleran CM, Holcomb R, Operario D, Calabrese SK, et al. Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US. PLoS ONE. 2014;9(11):e112425.CrossRefPubMedPubMedCentral Underhill K, Morrow KM, Colleran CM, Holcomb R, Operario D, Calabrese SK, et al. Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US. PLoS ONE. 2014;9(11):e112425.CrossRefPubMedPubMedCentral
Metadata
Title
Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs
Authors
E. Jennifer Edelman
Brent A. Moore
Sarah K. Calabrese
Gail Berkenblit
Chinazo Cunningham
Viraj Patel
Karran Phillips
Jeanette M. Tetrault
Minesh Shah
David A. Fiellin
Oni Blackstock
Publication date
01-04-2017
Publisher
Springer US
Published in
AIDS and Behavior / Issue 4/2017
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-016-1612-6

Other articles of this Issue 4/2017

AIDS and Behavior 4/2017 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine