1318. Are we PrEPared? Awareness and Prescribing Patterns of HIV Pre-Exposure Prophylaxis (PrEP) by Internal Medicine Resident Physicians at an Academic Medical Center
Session: Poster Abstract Session: Medical Education
Friday, October 5, 2018
Room: S Poster Hall
Background: HIV PrEP uptake remains low by primary care physicians, amongst whom increased awareness has been positively associated with its adoption. Prior studies have also revealed deficits in knowledge and comfort providing PrEP amongst internal medicine (IM) trainees. This is among the first reports of assessing PrEP uptake by IM residents; this appears to be the first examining pre- and post-instruction assessment of prescribing attitudes following a single lecture on the topic.

Methods: An anonymous, online survey was distributed to all IM residents at our institution to measure baseline PrEP awareness and prescribing patterns. A comprehensive PrEP lecture was formulated with assistance from infectious diseases (ID) faculty; focus was paid to addressing concerns about cost, safety, risk behavior compensation, and drug resistance. The lecture was made available electronically to those unable to attend the live session. PrEP knowledge and prescribing attitudes were measured and compared pre- and post-lecture. Fisher’s exact test was used for descriptive statistics.

Results: Of 97 initial surveys distributed, 41 were completed. A majority of respondents were aware of PrEP (68%). A modest number had either prescribed PrEP or referred a prospective patient to an ID specialist in the prior year (15%). The majority preferred to learn about PrEP with a dedicated didactic session (76%). Compared with baseline data, following the lecture, residents were better able to identify both the number of daily pills required (100% vs 49%, p = 0.007) and the proper medication regimen (100% vs 49%, p = 0.007); there was no significant difference in self-reported comfort with providing PrEP (89 vs 65%, p = 0.25). In the post-lecture survey, nearly half reported a preference to refer a PrEP candidate to an ID specialist or PrEP clinic (43%).

Conclusion: These findings suggest value in providing PrEP education to IM trainees, but indicate that a single lecture may not be effective for ultimately improving its adoption by this important group of physicians. Determining the optimal method for incorporating PrEP into residency curricula deserves further study. Despite efforts to expand PrEP into the realm of primary care, many of these physicians may continue to defer management of these patients to ID/HIV clinicians.

J. Patrik Hornak, MD, Internal Medicine, University of Texas Medical Branch, Galveston, TX

Disclosures:

J. P. Hornak, None

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