title: Attitude towards antiretroviral Pre-Exposure Prophylaxis (PrEP) prescription among HIV specialists.
abstract: BACKGROUND
  To investigate perceptions and attitude to prescribe Pre-Exposure Prophylaxis (PrEP) among HIV specialists.
  
  
  METHODS
  A questionnaire developed through a Focus Group and literature review was administered to a convenience sample of HIV specialists during educational courses in two Regions and an online survey in February-May 2012. Participants were classified as having a positive or negative attitude according to their willingness to prescribe PrEP. Demographic and working information, experience with HIV-infected patients, information and provision of antiretrovirals to uninfected persons, self-reported knowledge, perceptions and concerns regarding PrEP were assessed. The association between a different attitude towards PrEP prescription and selected characteristics was assessed through univariate and multivariate regression analysis.
  
  
  RESULTS
  Of 311 specialists, 70% would prescribe PrEP, mainly to serodiscordant partners (64%) but also to people at ongoing, high risk of HIV infection (56%); 66% advocated public support of costs. A negative attitude towards PrEP was significantly associated with lack of provision of information on, and prescription of, antiretroviral post-exposure prophylaxis; specialists with a negative attitude believed behavioural interventions to be more effective than PrEP and were more concerned about toxicity. Overall, 90% of specialists disagreed regarding a lack of time for engaging in prevention counselling and PrEP monitoring; 79% would welcome formal guidelines, while those with a negative attitude did not consider this advisable.
  
  
  CONCLUSIONS
  Although conflicting attitudes appear evident, most specialists seem to be willing, with guidance from normative bodies, to promote PrEP within multiple prevention strategies among vulnerable populations. More scientific evidence regarding effectiveness could overcome resistance.
authors.affiliation: UOC Infezioni emergenti e Centro di riferimento AIDS - Department of Epidemiology, National Institute for Infectious Diseases Lazzaro Spallanzani - IRCCS, via Portuense, 292, 00161, Rome, Italy. vincenzo.puro@inmi.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Puro
authors.forename: Antonio
authors.initials: A
authors.lastname: Palummieri
authors.forename: Gabriella
authors.initials: G
authors.lastname: De Carli
authors.forename: Pierluca
authors.initials: P
authors.lastname: Piselli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D011307:Drug Prescriptions; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents