PrEP Awareness and Attitudes in a National Survey of Primary Care Clinicians in the United States, 2009-2015.
PrEP Awareness and Attitudes in a National Survey of Primary Care Clinicians in the United States, 2009-2015.
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DOI：
10.1371/journal.pone.0156592
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Rose CE
中科院分区：
文献类型：
--
作者：
Smith DK;Mendoza MC;Stryker JE;Rose CE
由于试验正在评估每日口服抗逆转录病毒暴露前预防（PrEP）预防HIV感染的安全性和有效性，因此显然需要了解初级保健临床医生对PrEP的知识和态度的演变。2009年，医生和护士接受了调查（n = 1 500），2010年（n = 1504），2012年（n = 1503），2013年（n = 1507），2014年（n = 1508）和2015年（n = 1501）评估他们对PrEP的认识，开PrEP的意愿，以及他们是否支持使用公共资金支付PrEP。仅在2012年对Pharmacopoeia（n = 251）进行了关于PrEP的调查。计算医生人口统计学和PrEP相关问题的描述性统计量。使用Poisson回归分析计算处方PrEP意愿的患病率。临床医生对PrEP的认识较低（2009年：24%，2010年：29%），但在试验报告有效性后有所增加（2012年：49%，2013年：51%，2014年：61%，2015年：66%）。在描述了PrEP的估计有效性为75%之后，在6年的研究中，91%的临床医生表示愿意为至少一个HIV感染高风险群体开具PrEP。一个较小的大多数临床医生表示支持公共资金的准备在2009年：59%，2010年：53%，2013年：63%。在PrEP试验结果发布之前和之后进行的调查中，初级保健临床医生基本上不知道PrEP。他们表示非常愿意为艾滋病毒感染高风险的患者开处方，并表示有兴趣了解如何提供这种新的临床艾滋病毒预防方法。随着美国PrEP使用的增加，继续监测临床医生的知识、态度和实践将非常重要。
As trials were assessing the safety and efficacy of daily oral antiretroviral preexposure prophylaxis (PrEP) for the prevention of HIV infection, there was a clear need to understand the evolution of knowledge of, and attitudes toward, PrEP among primary care clinicians. Physicians and nurse practitioners were surveyed in 2009 (n = 1500), 2010 (n = 1504), 2012 (n = 1503), 2013 (n = 1507), 2014 (n = 1508) and 2015 (n = 1501) to assess their awareness of PrEP, willingness to prescribe PrEP, and whether they support use of public funds to pay for PrEP. Pharmacists (n = 251) were surveyed about PrEP in 2012 only. Descriptive statistics were computed for physician demographics and PrEP-related questions. Prevalence ratios for willingness to prescribe PrEP were computed using Poisson regression analysis. Awareness of PrEP was low among clinicians (2009: 24%, 2010: 29%) but increased after trials reported effectiveness (2012: 49%, 2013: 51%, 2014: 61%, 2015: 66%). Following a description of PrEP with an estimated effectiveness of 75%, across 6 of the study years 91% of clinicians indicated a willingness to prescribe PrEP to at least one group at high risk of HIV acquisition. A smaller majority of clinicians indicated support for public funding of PrEP in 2009: 59%, 2010: 53%, and 2013: 63%. In surveys conducted before and after the release of PrEP trial results, primary care clinicians were largely unaware of PrEP. They indicated high levels of willingness to prescribe it for patients at high risk of HIV acquisition and expressed interest in education about how to deliver this new clinical HIV prevention method. It will be important to continue monitoring clinician knowledge, attitudes, and practices as the use of PrEP increases in the US.