title: Primary Care Physicians' Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs.
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.
authors.affiliation: Yale University School of Medicine, 367 Cedar Street, ESH A, suite 401, New Haven, CT, 06510, USA. ejennifer.edelman@yale.edu.|Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA. ejennifer.edelman@yale.edu.|Yale University School of Public Health, New Haven, CT, USA. ejennifer.edelman@yale.edu.
authors.forename: E Jennifer
authors.initials: EJ
authors.lastname: Edelman
authors.affiliation: Yale University School of Medicine, 367 Cedar Street, ESH A, suite 401, New Haven, CT, 06510, USA.|Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Moore
authors.affiliation: Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA.|Yale University School of Public Health, New Haven, CT, USA.|George Washington University, Washington, DC, USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Calabrese
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Berkenblit
authors.affiliation: Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Chinazo
authors.initials: C
authors.lastname: Cunningham
authors.affiliation: Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Viraj
authors.initials: V
authors.lastname: Patel
authors.affiliation: NIDA-IRP, NIH, Baltimore, MD, USA.
authors.forename: Karran
authors.initials: K
authors.lastname: Phillips
authors.affiliation: Yale University School of Medicine, 367 Cedar Street, ESH A, suite 401, New Haven, CT, 06510, USA.
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Tetrault
authors.affiliation: University of Illinois - Chicago, Chicago, IL, USA.
authors.forename: Minesh
authors.initials: M
authors.lastname: Shah
authors.affiliation: Yale University School of Medicine, 367 Cedar Street, ESH A, suite 401, New Haven, CT, 06510, USA.|Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA.|Yale University School of Public Health, New Haven, CT, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.affiliation: Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Oni
authors.initials: O
authors.lastname: Blackstock
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission*; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058007:Physicians, Primary Care / Q000523:psychology*; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D014481:United States; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D019380:Anti-HIV Agents
keywords: Attitude of health personnel; HIV prevention; Pre-exposure prophylaxis; Substance abuse