HIV medical providers' perceptions of the use of antiretroviral therapy as nonoccupational postexposure prophylaxis in 2 major metropolitan areas

Allan E Rodriguez, Amanda D. Castel, Carrigan L. Parish, Sarah Willis, Daniel J Feaster, Michael Kharfen, Gabriel A. Cardenas, Kira Villamizar, Michael A Kolber, Liliana Vázquez-Rivera, Lisa R. Metsch

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

INTRODUCTION: In 2005, the Centers for Disease Control and Prevention expanded its recommendation of postexposure prophylaxis (PEP) use in the workplace to include nonoccupational exposures (nPEP). The availability and extensive use of nPEP have not achieved widespread acceptance among health-care providers of high-risk populations, and public health and primary care agencies have been sparse in their implementation of nPEP promotion, protocols, and practices. METHODS: We conducted a survey of HIV providers (n = 142, response rate = 61%) in Miami-Dade County (Florida) and the District of Columbia that focused on their knowledge, attitudes, beliefs, and practices related to the delivery of nPEP. We then analyzed differences in survey responses by site and by history of prescribing nPEP using bivariate and multivariate logistic regression. RESULTS: More District of Columbia providers (59.7%) reported ever prescribing nPEP than in Miami (39.5%, P < 0.048). The majority of practices in both cities did not have a written nPEP protocol and rarely or never had patients request nPEP. Multivariable analysis for history of prescribing nPEP was dominated by having patients request nPEP [odds ratio (OR) = 21.53] and the belief that nPEP would lead to antiretroviral resistance (OR = 0.14) and having a written nPEP protocol (OR = 7.49). DISCUSSION: Our findings are consistent with earlier studies showing the underuse of nPEP as a prevention strategy. The significance of having a written nPEP protocol and of patient requests for nPEP speaks to the importance of using targeted strategies to promote widespread awareness of the use of HIV antiretroviral medications as a prevention intervention.

Original languageEnglish
JournalJournal of Acquired Immune Deficiency Syndromes
Volume64
Issue numberSUPPL. 1
DOIs
StatePublished - Nov 1 2013

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Odds Ratio
HIV
Health Knowledge, Attitudes, Practice
Centers for Disease Control and Prevention (U.S.)
Workplace
Health Personnel
Primary Health Care
Therapeutics
Public Health
Logistic Models
Delivery of Health Care
Population
Surveys and Questionnaires

Keywords

  • Antiretroviral prophylaxis
  • HIV medical providers
  • HIV prevention
  • Nonoccupational exposure

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

HIV medical providers' perceptions of the use of antiretroviral therapy as nonoccupational postexposure prophylaxis in 2 major metropolitan areas. / Rodriguez, Allan E; Castel, Amanda D.; Parish, Carrigan L.; Willis, Sarah; Feaster, Daniel J; Kharfen, Michael; Cardenas, Gabriel A.; Villamizar, Kira; Kolber, Michael A; Vázquez-Rivera, Liliana; Metsch, Lisa R.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 64, No. SUPPL. 1, 01.11.2013.

Research output: Contribution to journalArticle

Rodriguez, Allan E ; Castel, Amanda D. ; Parish, Carrigan L. ; Willis, Sarah ; Feaster, Daniel J ; Kharfen, Michael ; Cardenas, Gabriel A. ; Villamizar, Kira ; Kolber, Michael A ; Vázquez-Rivera, Liliana ; Metsch, Lisa R. / HIV medical providers' perceptions of the use of antiretroviral therapy as nonoccupational postexposure prophylaxis in 2 major metropolitan areas. In: Journal of Acquired Immune Deficiency Syndromes. 2013 ; Vol. 64, No. SUPPL. 1.
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abstract = "INTRODUCTION: In 2005, the Centers for Disease Control and Prevention expanded its recommendation of postexposure prophylaxis (PEP) use in the workplace to include nonoccupational exposures (nPEP). The availability and extensive use of nPEP have not achieved widespread acceptance among health-care providers of high-risk populations, and public health and primary care agencies have been sparse in their implementation of nPEP promotion, protocols, and practices. METHODS: We conducted a survey of HIV providers (n = 142, response rate = 61{\%}) in Miami-Dade County (Florida) and the District of Columbia that focused on their knowledge, attitudes, beliefs, and practices related to the delivery of nPEP. We then analyzed differences in survey responses by site and by history of prescribing nPEP using bivariate and multivariate logistic regression. RESULTS: More District of Columbia providers (59.7{\%}) reported ever prescribing nPEP than in Miami (39.5{\%}, P < 0.048). The majority of practices in both cities did not have a written nPEP protocol and rarely or never had patients request nPEP. Multivariable analysis for history of prescribing nPEP was dominated by having patients request nPEP [odds ratio (OR) = 21.53] and the belief that nPEP would lead to antiretroviral resistance (OR = 0.14) and having a written nPEP protocol (OR = 7.49). DISCUSSION: Our findings are consistent with earlier studies showing the underuse of nPEP as a prevention strategy. The significance of having a written nPEP protocol and of patient requests for nPEP speaks to the importance of using targeted strategies to promote widespread awareness of the use of HIV antiretroviral medications as a prevention intervention.",
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AU - Rodriguez, Allan E

AU - Castel, Amanda D.

AU - Parish, Carrigan L.

AU - Willis, Sarah

AU - Feaster, Daniel J

AU - Kharfen, Michael

AU - Cardenas, Gabriel A.

AU - Villamizar, Kira

AU - Kolber, Michael A

AU - Vázquez-Rivera, Liliana

AU - Metsch, Lisa R.

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N2 - INTRODUCTION: In 2005, the Centers for Disease Control and Prevention expanded its recommendation of postexposure prophylaxis (PEP) use in the workplace to include nonoccupational exposures (nPEP). The availability and extensive use of nPEP have not achieved widespread acceptance among health-care providers of high-risk populations, and public health and primary care agencies have been sparse in their implementation of nPEP promotion, protocols, and practices. METHODS: We conducted a survey of HIV providers (n = 142, response rate = 61%) in Miami-Dade County (Florida) and the District of Columbia that focused on their knowledge, attitudes, beliefs, and practices related to the delivery of nPEP. We then analyzed differences in survey responses by site and by history of prescribing nPEP using bivariate and multivariate logistic regression. RESULTS: More District of Columbia providers (59.7%) reported ever prescribing nPEP than in Miami (39.5%, P < 0.048). The majority of practices in both cities did not have a written nPEP protocol and rarely or never had patients request nPEP. Multivariable analysis for history of prescribing nPEP was dominated by having patients request nPEP [odds ratio (OR) = 21.53] and the belief that nPEP would lead to antiretroviral resistance (OR = 0.14) and having a written nPEP protocol (OR = 7.49). DISCUSSION: Our findings are consistent with earlier studies showing the underuse of nPEP as a prevention strategy. The significance of having a written nPEP protocol and of patient requests for nPEP speaks to the importance of using targeted strategies to promote widespread awareness of the use of HIV antiretroviral medications as a prevention intervention.

AB - INTRODUCTION: In 2005, the Centers for Disease Control and Prevention expanded its recommendation of postexposure prophylaxis (PEP) use in the workplace to include nonoccupational exposures (nPEP). The availability and extensive use of nPEP have not achieved widespread acceptance among health-care providers of high-risk populations, and public health and primary care agencies have been sparse in their implementation of nPEP promotion, protocols, and practices. METHODS: We conducted a survey of HIV providers (n = 142, response rate = 61%) in Miami-Dade County (Florida) and the District of Columbia that focused on their knowledge, attitudes, beliefs, and practices related to the delivery of nPEP. We then analyzed differences in survey responses by site and by history of prescribing nPEP using bivariate and multivariate logistic regression. RESULTS: More District of Columbia providers (59.7%) reported ever prescribing nPEP than in Miami (39.5%, P < 0.048). The majority of practices in both cities did not have a written nPEP protocol and rarely or never had patients request nPEP. Multivariable analysis for history of prescribing nPEP was dominated by having patients request nPEP [odds ratio (OR) = 21.53] and the belief that nPEP would lead to antiretroviral resistance (OR = 0.14) and having a written nPEP protocol (OR = 7.49). DISCUSSION: Our findings are consistent with earlier studies showing the underuse of nPEP as a prevention strategy. The significance of having a written nPEP protocol and of patient requests for nPEP speaks to the importance of using targeted strategies to promote widespread awareness of the use of HIV antiretroviral medications as a prevention intervention.

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