A Preliminary Study of the Attitudes and Barriers of Family Physicians to Prescribing HIV Preexposure Prophylaxis

INTRODUCTION: Attitudes of individuals who provide HIV care towards prescribing Preexposure Prophylaxis (PrEP) to at-risk populations have been studied, but few studies indicate if family physicians would be willing to prescribe PrEP as most family physicians do not specialize in HIV medicine. Few data exist on the perceived barriers preventing family physicians from prescribing PrEP. The purpose of this project was to assess the attitudes and perceived barriers of family physicians in Kansas towards prescribing PrEP to high risk patient populations. METHODS: This study was a descriptive, observational, and cross-sectional survey of family physicians who respond to email surveys issued through the Family Medicine Research and Data Information Office (FM RADIO). RESULTS: Fifty-three percent of family physicians take a sexual history on new patients less than frequently, and only 35% frequently ask about the use of safe sex practices. Only 29% frequently ask if the patient has sex with men, women, or both. Seventy-six percent of respondents would be willing to prescribe PrEP to men who have sex with men, and an equal percentage would be willing to prescribe to heterosexually active men and women who are at substantial risk of acquiring HIV. While 59% of participants agreed that PrEP belongs in the primary care domain of treatment, 71% agreed that they had limited or no knowledge of PrEP guidelines. CONCLUSIONS: This preliminary study indicated a need for increased family physician screening of new patients for high risk sexual behaviors who would be eligible for PrEP. The limited knowledge of PrEP guidelines and its use in clinical practice are significant limiting factors to increasing prescribing practices in the family medicine community rather than a perceived ethical dilemma of prescribing PrEP to men who have sex with men. As a result, an increase in continuing medical education about PrEP could significantly increase its prescribing in the family medicine community.