490. Pre-Exposure Prophylaxis (PrEP) for HIV: An Online Survey of HIV Healthcare Providers Evaluating their Knowledge, Perception, and Prescription of PrEP
Session: Poster Abstract Session: HIV Testing and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • PrEP Poster.pdf (536.1 kB)
  • Background:  The use of antiretrovirals to prevent HIV transmission in uninfected individuals has been evaluated in the iPrEX, FEM-PrEP, and CAPRISA studies, and has recently been addressed by the CDC’s interim guidance on the use of PrEP.  With its high cost, adherence challenges and questions surrounding resistance, healthcare providers’ knowledge, attitudes, and prescribing practices of PrEP are of significant importance.

    Methods:  In Spring, 2011, we began an ongoing study using an on-line, 21-question survey. It was sent to members of the American Academy of HIV Medicine, a national organization of about 2000 HIV practitioners and credentialed HIV specialists. Participants were asked about their knowledge, perceptions and concerns about PrEP, as well as their prescribing practices.

    Results:  Of the 148 participants completing the survey, 51% (N=75) were male, 45% (N=66) were > 50 years, and 81% (N=120) cared for > 20 HIV+ patients monthly.  The majority (90%, N=133) were familiar with the iPrEX study and the CDC’s “interim guidance” regarding PrEP (76%, N=112).  Although 39% (N=55) had patients who requested PrEP, only 18% (N=25) prescribed it. Of these, 77% (N=17) prescribed FTC/TDF; 73% (N=16) gave PrEP to MSM, 36% (N=8) to MSW, and 27% (N=6) to WSM.  When asked why PrEP was discontinued, 27% (N=6) stated patient preference, 23% (N=5) said patients were no longer at high risk for HIV, 18% (N=4) cited medication non-compliance, and 18% (N=4) reported cost.  Greatest concerns about prescribing PrEP included: development of antiretroviral resistance - 33% (N=44), potential increase in high risk behavior - 22% (N=29), and cost - 11% (N=15).

    Conclusion:  Despite many unanswered questions about PrEP, this survey indicates that it is being prescribed to both men and women, independent of sexual orientation, by HIV-knowledgeable healthcare providers.  Furthermore, the knowledge base and opinions regarding PrEP differed significantly among respondents. With the recent results from FEM-PrEP, we plan to continue our survey to monitor for changes in healthcare providers’ knowledge, attitudes, and prescribing practices of this controversial HIV prevention method.


    Subject Category: H. HIV/AIDS and other retroviruses

    Khalid Maznavi, MD1, David Hardy, MD1 and Fritz Bredeek, MD, PhD, FACP2, (1)Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, (2)Infectious Diseases, University of California, Los Angeles, Sylmar, CA

    Disclosures:

    K. Maznavi, None

    D. Hardy, Gilead Sciences: Research Contractor and Scientific Advisor, Consulting fee, Educational grant and Research grant
    ViiV Healhhcare: Research Contractor and Scientific Advisor, Consulting fee and Research grant
    Merck : Research Contractor and Scientific Advisor, Consulting fee, Educational grant and Research grant
    TIbotec : Member of DSMB, Research Contractor and Scientific Advisor, Consulting fee, Educational grant and Research grant

    F. Bredeek, Gilead: Investigator, Scientific Advisor and Speaker's Bureau, Consulting fee, Research support and Speaker honorarium

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.