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Primary care providers in Tennessee show low pre-exposure prophylaxis (PrEP) prescribing. Increased PrEP knowledge and comfort with sexual history-taking are linked to higher PrEP prescription rates, suggesting targets for improving HIV prevention.

Keywords:
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Area of Science:

  • Public Health
  • Infectious Diseases
  • Primary Care Medicine

Background:

  • Pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention.
  • Low PrEP utilization is observed in the Southern US, despite high HIV prevalence.
  • Assessing PrEP knowledge and practices among primary care providers (PCPs) in Tennessee is crucial.

Purpose of the Study:

  • To evaluate PrEP knowledge, attitudes, and prescribing behaviors among Tennessee PCPs.
  • To identify factors associated with PrEP prescribing practices in primary care settings.

Main Methods:

  • An anonymous, cross-sectional electronic survey was administered to Tennessee PCPs.
  • The survey assessed PrEP prescription history, knowledge, attitudes, and provider/practice characteristics.
  • Statistical analyses compared prescribers and non-prescribers using Wilcoxon rank-sum and Fisher's exact tests.

Main Results:

  • Of 99 eligible respondents, 43% reported prescribing PrEP in the past year.
  • PrEP prescribers demonstrated significantly higher knowledge scores and patient inquiry rates.
  • Prescribers reported greater comfort and ability in taking sexual histories, particularly from men who have sex with men.

Conclusions:

  • PrEP provision is strongly associated with provider knowledge and comfort with sexual history-taking.
  • These factors represent potential targets for interventions to increase PrEP uptake.
  • Further research is needed to establish temporal relationships and optimize PrEP delivery in primary care.