PMID- 28902704
OWN - NLM
STAT- MEDLINE
DCOM- 20171219
LR  - 20180223
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Linking)
VI  - 77
IP  - 1
DP  - 2018 Jan 1
TI  - HIV Preexposure Prophylaxis Implementation at Local Health Departments: A
      Statewide Assessment of Activities and Barriers.
PG  - 72-77
LID - 10.1097/QAI.0000000000001546 [doi]
AB  - BACKGROUND: Expanding access to HIV preexposure prophylaxis (PrEP) could help
      reduce rates of HIV infection in the United States. This study characterizes
      activities and barriers to PrEP implementation at local health departments (LHDs)
      in North Carolina (NC), which contains a large rural population. METHODS: In May 
      2016, a web-based survey was distributed to health directors of all county and
      district health departments in NC to assess PrEP-related activities, perceived
      barriers to PrEP implementation, and desired PrEP-related resources. RESULTS: Of 
      85 LHDs in NC, 56 (66%) responded to the survey. Of these, 2 (4%) reported PrEP
      prescribing and 7 (13%) externally referred for PrEP services. Among the 54
      departments not prescribing PrEP, the most frequently cited reasons were cost
      concerns (n = 25, 46%), lack of formal prescribing protocols (n = 21, 39%), and
      belief that PrEP would be better managed at primary care or specialty clinics (n 
      = 19, 35%). Among the 47 departments not prescribing or referring clients for
      PrEP, the most frequently cited reasons for the lack of PrEP referral were the
      absence of local PrEP providers (n = 29, 62%), lack of PrEP knowledge among staff
      (n = 13, 28%), and perceived lack of PrEP candidates (n = 12, 26%). The most
      frequently requested PrEP-related resources included training to help identify
      PrEP candidates (n = 39, 70%) and training on PrEP prescribing and management (n 
      = 38, 68%). CONCLUSIONS: PrEP prescribing and referral among LHDs in NC remains
      extremely limited. Increased PrEP-related training and support for LHD-based
      providers could enhance PrEP access, especially in rural and underserved areas.
FAU - Zhang, Helen L
AU  - Zhang HL
AD  - Department of Medicine, Duke University Medical Center, Durham, NC.
FAU - Rhea, Sarah K
AU  - Rhea SK
AD  - North Carolina Department of Health and Human Services, Raleigh, NC.
FAU - Hurt, Christopher B
AU  - Hurt CB
AD  - Department of Medicine, Institute for Global Health and Infectious Diseases,
      University of North Carolina at Chapel Hill, Chapel Hill, NC.
FAU - Mobley, Victoria L
AU  - Mobley VL
AD  - North Carolina Department of Health and Human Services, Raleigh, NC.
FAU - Swygard, Heidi
AU  - Swygard H
AD  - North Carolina Department of Health and Human Services, Raleigh, NC.
AD  - Department of Medicine, Institute for Global Health and Infectious Diseases,
      University of North Carolina at Chapel Hill, Chapel Hill, NC.
FAU - Sena, Arlene C
AU  - Sena AC
AD  - Department of Medicine, Institute for Global Health and Infectious Diseases,
      University of North Carolina at Chapel Hill, Chapel Hill, NC.
AD  - Durham County Department of Public Health, Durham, NC.
FAU - McKellar, Mehri S
AU  - McKellar MS
AD  - Division of Infectious Diseases, Department of Medicine, Duke University Medical 
      Center, Durham, NC.
LA  - eng
GR  - K23 MH099941/MH/NIMH NIH HHS/United States
GR  - P30 AI050410/AI/NIAID NIH HHS/United States
GR  - P30 AI064518/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
RN  - 0 (Anti-HIV Agents)
SB  - IM
SB  - X
MH  - Adult
MH  - Anti-HIV Agents/therapeutic use
MH  - *Attitude of Health Personnel
MH  - Female
MH  - HIV Infections/drug therapy/epidemiology/*prevention & control
MH  - Health Personnel/*education
MH  - *Health Plan Implementation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - North Carolina/epidemiology
MH  - *Pre-Exposure Prophylaxis
MH  - Referral and Consultation
MH  - Surveys and Questionnaires
PMC - PMC5720898
MID - NIHMS904767
EDAT- 2017/09/14 06:00
MHDA- 2017/12/20 06:00
CRDT- 2017/09/14 06:00
PMCR- 2019/01/01 00:00
PHST- 2019/01/01 00:00 [pmc-release]
PHST- 2017/09/14 06:00 [pubmed]
PHST- 2017/12/20 06:00 [medline]
PHST- 2017/09/14 06:00 [entrez]
AID - 10.1097/QAI.0000000000001546 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2018 Jan 1;77(1):72-77. doi:
      10.1097/QAI.0000000000001546.