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AIDS Care. 2018 May;30(5):650-655. doi: 10.1080/09540121.2017.1384534. Epub 2017 Oct 3.

An educational initiative in response to identified PrEP prescribing needs among PCPs in the Southern U.S.

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a Division of Infectious Diseases , Duke University Medical Center , Durham , NC , USA.
b Duke Clinical Research Institute , Durham , NC , USA.
c Duke Department of Biostatistics and Bioinformatics , Duke University , Durham , NC , USA.
d Duke University School of Medicine , Durham , NC , USA.


Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, but many primary care physicians (PCPs) have not incorporated PrEP into practice. While PrEP may be a key strategy to reducing high HIV transmission rates in the southern US, knowledge about PrEP prescribing patterns among PCPs in this region is lacking. An online survey was sent to a large network of PCPs at an academic medical center in North Carolina in October 2015. The survey was repeated in September 2016, after an educational intervention that included on-site trainings at 14 PCP offices. Chi-square tests were used to compare PrEP prescribing patterns among providers. The initial survey was sent to 389 PCPs, with 115 (30%) responding. Of these, 78% reported seeing men who have sex with men (MSM). Only 17% had prescribed PrEP. The most frequently identified barrier was lack of knowledge (60%). When the survey was repeated after the educational initiative, 79 PCPs (20%) responded. Of these, 90% reported seeing MSM, and 35% had prescribed PrEP. PCPs who had attended a training were more likely to have prescribed PrEP (OR 4.84, CI 1.77-13.21). In conclusion, PrEP prescribing among PCPs in the southern US is low. A survey among PCPs identified lack of knowledge as a barrier to prescribing, motivating an institutional-wide educational campaign in response. Further efforts are needed to continue to raise awareness and educate PCPs in the South about PrEP.


PCPs; PrEP; Pre-exposure prophylaxis; primary care providers; southern United States

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