title: United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.
abstract: 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 preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US 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.
  
  
  
  Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed.
  
  
  
  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% confidence interval (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 years, 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.
  
  
  
  To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing.
  
  
  
  US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods.
authors.affiliation: University of California, San Francisco, 1001 Potrero Ave Ward 6D, San Francisco, CA, 94110, United States. Electronic address: Dominika.seidman@ucsf.edu.
authors.forename: Dominika
authors.initials: D
authors.lastname: Seidman
authors.affiliation: National Clinical Training Center for Family Planning, University of Missouri, Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108, United States. Electronic address: karlsonkim@umkc.edu.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Carlson
authors.affiliation: University of California, San Francisco, 1001 Potrero Ave Ward 6D, San Francisco, CA, 94110, United States; HIVE, 1001 Potrero Ave Ward 6D, San Francisco, CA, 94110, United States. Electronic address: Shannon.weber@ucsf.edu.
authors.forename: Shannon
authors.initials: S
authors.lastname: Weber
authors.affiliation: National Clinical Training Center for Family Planning, University of Missouri, Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108, United States. Electronic address: wittj@umkc.edu.
authors.forename: Jacki
authors.initials: J
authors.lastname: Witt
authors.affiliation: National Clinical Training Center for Family Planning, University of Missouri, Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108, United States. Electronic address: kellypj@umkc.edu.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Kelly
mesh_terms: D000328:Adult; D005193:Family Planning Services; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D011795:Surveys and Questionnaires; D014481:United States; D016387:Women's Health; D055815:Young Adult
keywords: Family planning; HIV prevention; PrEP; Preexposure prophylaxis; Women