A Preliminary Study of the Attitudes and Barriers of Family Physicians to Prescribing HIV Preexposure Prophylaxis

Abstract

Introduction. Attitudes of individuals who provide HIV care
towards prescribing Preexposure Prophylaxis (PrEP) to at-risk
populations have been studied, but few studies indicate if family
physicians would be willing to prescribe PrEP as most family
physicians do not specialize in HIV medicine. Few data exist
on the perceived barriers preventing family physicians from
prescribing PrEP. The purpose of this project was to assess the
attitudes and perceived barriers of family physicians in Kansas
towards prescribing PrEP to high risk patient populations.

Methods. This study was a descriptive, observational,
and cross-sectional survey of family physicians who respond
to email surveys issued through the Family Medicine
Research and Data Information Office (FM RADIO).

Results. Fifty-three percent of family physicians take a sexual
history on new patients less than frequently, and only
35% frequently ask about the use of safe sex practices. Only
29% frequently ask if the patient has sex with men, women,
or both. Seventy-six percent of respondents would be willing
to prescribe PrEP to men who have sex with men, and an
equal percentage would be willing to prescribe to heterosexually
active men and women who are at substantial risk of acquiring
HIV. While 59% of participants agreed that PrEP belongs
in the primary care domain of treatment, 71% agreed
that they had limited or no knowledge of PrEP guidelines.

Conclusions. This preliminary study indicated a need for increased
family physician screening of new patients for high risk
sexual behaviors who would be eligible for PrEP. The limited
knowledge of PrEP guidelines and its use in clinical practice
are significant limiting factors to increasing prescribing practices
in the family medicine community rather than a perceived
ethical dilemma of prescribing PrEP to men who have sex with
men. As a result, an increase in continuing medical education
about PrEP could significantly increase its prescribing in
the family medicine community. KS J Med 2017;10(2):40-42.