Roughly one-quarter of HIV care providers in the United States who treat uninfected patients have prescribed pre-exposure prophylaxis, or PrEP, a drug meant to prevent HIV infection, according to a study.
“In all, a relatively small proportion of these providers had prescribed PrEP, considering the large body of evidence supporting its effectiveness, their familiarity with prescribing [Truvada (emtricitabine/tenofovir disoproxil fumarate, Gilead Sciences)] … and their experience providing other HIV risk reduction practices,” the researchers wrote.
The survey was conducted by researchers at the CDC’s Division of HIV/AIDS Prevention. It included information on treatment rendered in 2013 and 2014 by 935 HIV care providers in the U.S. who treated uninfected patients.
Overall, 26% of respondents said they had written at least one script for PrEP. Of those, 74% prescribed it for men who have sex with men, 30% for women who have sex with men, 23% for men who have sex with women, 23% for those with HIV–infected partners with whom they were trying to conceive a child, and 1% for people who inject drugs (PWID).
Thirty-two percent of male providers had prescribed the drug, compared with 16% of their female colleagues. In addition, 50% of lesbian, gay and bisexual providers did so vs. 21% of heterosexual providers.
The researchers noted previous studies showing that significant proportions of physicians were less comfortable discussing sexual history with patients of the opposite sex. The relative unease is among several potential barriers to more effective HIV prevention.
“Additional efforts, including training to elicit comprehensive sexual health histories regardless of gender concordance, and training in the care of PWID, may enable more providers to prescribe PrEP to underserved patients who might benefit from this service,” they concluded. - by Joe Green
Disclosure: The researchers report no relevant financial disclosures.