Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention: Results from a survey of healthcare providers in New England

Douglas S. Krakower, Catherine E. Oldenburg, Jennifer A. Mitty, Ira B. Wilson, Ann E. Kurth, Kevin M. Maloney, Donna Gallagher, Kenneth H. Mayer

Research output: Contribution to journalArticle

Abstract

Background: Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and preexposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited. Methods: Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices. Results: Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01-1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98-11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06-1.34), whereas female gender (aOR 0.26, 95% CI 0.10-0.71) was associated with having not prescribed PrEP. Conclusions: These findings suggest many clinicians have shifted towards routinely recommending early ART, but not PrEP, so interventions to facilitate PrEP provision are needed.

Original languageEnglish (US)
Article numbere0132398
JournalPLoS One
Volume10
Issue number7
DOIs
StatePublished - Jul 6 2015

Fingerprint

chemoprevention
New England
New England region
Chemoprevention
Health Personnel
health services
drug therapy
HIV
HIV infections
HIV Infections
Department of Health and Human Services
Surveys and Questionnaires
United States Dept. of Health and Human Services
Disease control
educational institutions
Centers for Disease Control and Prevention
Primary Care Physicians
Centers for Disease Control and Prevention (U.S.)
physicians
infectious diseases

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Krakower, D. S., Oldenburg, C. E., Mitty, J. A., Wilson, I. B., Kurth, A. E., Maloney, K. M., ... Mayer, K. H. (2015). Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention: Results from a survey of healthcare providers in New England. PLoS One, 10(7), [e0132398]. https://doi.org/10.1371/journal.pone.0132398

Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention : Results from a survey of healthcare providers in New England. / Krakower, Douglas S.; Oldenburg, Catherine E.; Mitty, Jennifer A.; Wilson, Ira B.; Kurth, Ann E.; Maloney, Kevin M.; Gallagher, Donna; Mayer, Kenneth H.

In: PLoS One, Vol. 10, No. 7, e0132398, 06.07.2015.

Research output: Contribution to journalArticle

Krakower, DS, Oldenburg, CE, Mitty, JA, Wilson, IB, Kurth, AE, Maloney, KM, Gallagher, D & Mayer, KH 2015, 'Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention: Results from a survey of healthcare providers in New England', PLoS One, vol. 10, no. 7, e0132398. https://doi.org/10.1371/journal.pone.0132398
Krakower, Douglas S. ; Oldenburg, Catherine E. ; Mitty, Jennifer A. ; Wilson, Ira B. ; Kurth, Ann E. ; Maloney, Kevin M. ; Gallagher, Donna ; Mayer, Kenneth H. / Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention : Results from a survey of healthcare providers in New England. In: PLoS One. 2015 ; Vol. 10, No. 7.
@article{9845148bc34a4f6db8596b7d1f38d7fc,
title = "Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention: Results from a survey of healthcare providers in New England",
abstract = "Background: Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and preexposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited. Methods: Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices. Results: Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58{\%} were female, and 82{\%} were white. Among ART-prescribing clinicians (61{\%} of the entire sample), 64{\%} were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69{\%} indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77{\%} of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19{\%} had prescribed PrEP, and 58{\%} of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10{\%} increase in proportion of patients with HIV-infection, 95{\%} CI 1.01-1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95{\%} CI 0.98-11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95{\%} CI 1.06-1.34), whereas female gender (aOR 0.26, 95{\%} CI 0.10-0.71) was associated with having not prescribed PrEP. Conclusions: These findings suggest many clinicians have shifted towards routinely recommending early ART, but not PrEP, so interventions to facilitate PrEP provision are needed.",
author = "Krakower, {Douglas S.} and Oldenburg, {Catherine E.} and Mitty, {Jennifer A.} and Wilson, {Ira B.} and Kurth, {Ann E.} and Maloney, {Kevin M.} and Donna Gallagher and Mayer, {Kenneth H.}",
year = "2015",
month = "7",
day = "6",
doi = "10.1371/journal.pone.0132398",
language = "English (US)",
volume = "10",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "7",

}

TY - JOUR

T1 - Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention

T2 - Results from a survey of healthcare providers in New England

AU - Krakower, Douglas S.

AU - Oldenburg, Catherine E.

AU - Mitty, Jennifer A.

AU - Wilson, Ira B.

AU - Kurth, Ann E.

AU - Maloney, Kevin M.

AU - Gallagher, Donna

AU - Mayer, Kenneth H.

PY - 2015/7/6

Y1 - 2015/7/6

N2 - Background: Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and preexposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited. Methods: Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices. Results: Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01-1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98-11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06-1.34), whereas female gender (aOR 0.26, 95% CI 0.10-0.71) was associated with having not prescribed PrEP. Conclusions: These findings suggest many clinicians have shifted towards routinely recommending early ART, but not PrEP, so interventions to facilitate PrEP provision are needed.

AB - Background: Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and preexposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited. Methods: Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices. Results: Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01-1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98-11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06-1.34), whereas female gender (aOR 0.26, 95% CI 0.10-0.71) was associated with having not prescribed PrEP. Conclusions: These findings suggest many clinicians have shifted towards routinely recommending early ART, but not PrEP, so interventions to facilitate PrEP provision are needed.

UR - http://www.scopus.com/inward/record.url?scp=84940094707&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940094707&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0132398

DO - 10.1371/journal.pone.0132398

M3 - Article

AN - SCOPUS:84940094707

VL - 10

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 7

M1 - e0132398

ER -