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Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training

There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping...

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Autores principales: Cooper, Robert L., Juarez, Paul D., Morris, Matthew C., Ramesh, Aramandla, Edgerton, Ryan, Brown, Lauren L., Mena, Leandro, MacMaster, Samuel A., Collins, Shavonne, Juarez, Patricia Matthews-, Tabatabai, Mohammad, Brown, Katherine Y., Paul, Michael J., Im, Wansoo, Arcury, Thomas A., Shinn, Marybeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142521/
https://www.ncbi.nlm.nih.gov/pubmed/34027712
http://dx.doi.org/10.1177/00469580211017666
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author Cooper, Robert L.
Juarez, Paul D.
Morris, Matthew C.
Ramesh, Aramandla
Edgerton, Ryan
Brown, Lauren L.
Mena, Leandro
MacMaster, Samuel A.
Collins, Shavonne
Juarez, Patricia Matthews-
Tabatabai, Mohammad
Brown, Katherine Y.
Paul, Michael J.
Im, Wansoo
Arcury, Thomas A.
Shinn, Marybeth
author_facet Cooper, Robert L.
Juarez, Paul D.
Morris, Matthew C.
Ramesh, Aramandla
Edgerton, Ryan
Brown, Lauren L.
Mena, Leandro
MacMaster, Samuel A.
Collins, Shavonne
Juarez, Patricia Matthews-
Tabatabai, Mohammad
Brown, Katherine Y.
Paul, Michael J.
Im, Wansoo
Arcury, Thomas A.
Shinn, Marybeth
author_sort Cooper, Robert L.
collection PubMed
description There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision. Four overarching barriers presented in the literature: Purview Paradox, Patient Financial Constraints, Risk Compensation, and Concern for ART Resistance. Considering the physician-identified barriers, we make recommendations for how physicians and students may work to increase PrEP knowledge and competence along each stage of the PrEP cascade. We recommend adopting HIV risk assessment as a standard of care, improving physician ability to identify PrEP candidates, improving physician interest and ability in encouraging PrEP uptake, and increasing utilization of continuous care management to ensure retention and adherence to PrEP.
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spelling pubmed-81425212021-06-04 Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training Cooper, Robert L. Juarez, Paul D. Morris, Matthew C. Ramesh, Aramandla Edgerton, Ryan Brown, Lauren L. Mena, Leandro MacMaster, Samuel A. Collins, Shavonne Juarez, Patricia Matthews- Tabatabai, Mohammad Brown, Katherine Y. Paul, Michael J. Im, Wansoo Arcury, Thomas A. Shinn, Marybeth Inquiry Review Articles (excluding Systematic Reviews) There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision. Four overarching barriers presented in the literature: Purview Paradox, Patient Financial Constraints, Risk Compensation, and Concern for ART Resistance. Considering the physician-identified barriers, we make recommendations for how physicians and students may work to increase PrEP knowledge and competence along each stage of the PrEP cascade. We recommend adopting HIV risk assessment as a standard of care, improving physician ability to identify PrEP candidates, improving physician interest and ability in encouraging PrEP uptake, and increasing utilization of continuous care management to ensure retention and adherence to PrEP. SAGE Publications 2021-05-22 /pmc/articles/PMC8142521/ /pubmed/34027712 http://dx.doi.org/10.1177/00469580211017666 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles (excluding Systematic Reviews)
Cooper, Robert L.
Juarez, Paul D.
Morris, Matthew C.
Ramesh, Aramandla
Edgerton, Ryan
Brown, Lauren L.
Mena, Leandro
MacMaster, Samuel A.
Collins, Shavonne
Juarez, Patricia Matthews-
Tabatabai, Mohammad
Brown, Katherine Y.
Paul, Michael J.
Im, Wansoo
Arcury, Thomas A.
Shinn, Marybeth
Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training
title Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training
title_full Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training
title_fullStr Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training
title_full_unstemmed Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training
title_short Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training
title_sort recommendations for increasing physician provision of pre-exposure prophylaxis: implications for medical student training
topic Review Articles (excluding Systematic Reviews)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142521/
https://www.ncbi.nlm.nih.gov/pubmed/34027712
http://dx.doi.org/10.1177/00469580211017666
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