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Residents and Fellows’ Confidence in Prescribing Pre-Exposure Prophylaxis (PrEP)

Published:March 07, 2023DOI:https://doi.org/10.1016/j.acap.2023.02.017
Residents and Fellows’ Confidence in Prescribing Pre-Exposure Prophylaxis (PrEP)
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      Abstract

      Objectives

      Residents and fellows are often the first healthcare providers to discuss sexual health and prevention with adolescents and young adults (AYA) at academic institutions. This study characterized when learners in Pediatrics, Obstetrics and Gynecology, and Family Medicine believed that one should receive training in pre-exposure prophylaxis (PrEP) and it described confidence in prescribing PrEP.

      Methods

      Learners at a large, urban, southern academic center completed an online survey about adolescent sexual health services. Measures included whether participants were taught how to prescribe PrEP and how to do so in a confidential manner. Confidence in these two behaviors was measured with a Likert scale and dichotomized for bivariate analysis.

      Results

      Among the 228 respondents (63% response rate), most learners preferred sexual health communication to be emphasized early in medical school and throughout training. Overall, 44% reported being “not confident at all” in prescribing PrEP, and 22% were “not confident at all” in prescribing in a confidential manner. Those who reported “not confident at all" in prescribing PrEP were more likely in pediatrics (51%) than family medicine (23%) or obstetrics-gynecology (35%) (p < 0.01). Those who had been taught how to prescribe were more confident in prescribing PrEP (p ≤ 0.01) and prescribing in a confidential manner (p < 0.01).

      Conclusions

      Given the continued high rates of new HIV infections among adolescents, effective communication with patients eligible for PrEP is critical. Future studies should evaluate and inform tailored curricula about the importance of PrEP and build communication skills around confidential prescribing.

      Keywords

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      Article info

      Publication history

      Accepted: February 27, 2023
      Received in revised form: February 17, 2023
      Received: August 25, 2022

      Publication stage

      In Press Journal Pre-Proof

      Identification

      DOI: https://doi.org/10.1016/j.acap.2023.02.017

      Copyright

      © 2023 Published by Elsevier Inc.

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