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HIV Post-Exposure Prophylaxis (PEP) Awareness and Non-Occupational PEP (nPEP) Prescribing History Among U.S. Healthcare Providers

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Abstract

Non-occupational post-exposure prophylaxis (nPEP) has been clinically recommended since 2005. HIV providers and non-HIV providers (n = 480) practicing within above-average HIV prevalence ZIP codes of the 10 U.S. cities with greatest overall HIV prevalence participated in a cross-sectional survey between July 2014 and May 2015. Providers were asked about their awareness of post-exposure prophylaxis (PEP) and nPEP prescribing experience for patients with potential sexual exposures to HIV, which we coded into a PEP prescribing cascade with three categories: (1) PEP unaware, (2) PEP aware, no nPEP prescribing experience, and (3) nPEP prescribing experience. Overall, 12.5% were unaware of PEP, 43.5% were aware but hadn’t prescribed nPEP, and 44.0% had prescribed nPEP for potential sexual exposures to HIV. Fewer providers practicing in the U.S. South had ever prescribed nPEP compared to providers in other regions (χ2= 39.91, p < 0.001). HIV providers, compared to non-HIV providers, were more likely to be classified in the nPEP prescription group compared to the PEP aware without nPEP prescription group (RRR = 2.96, p < 0.001). PrEP prescribers, compared to those PrEP unaware, were more likely to be classified in the nPEP prescription group compared to PEP aware without nPEP prescription group (RRR = 12.49, p < 0.001).

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Acknowledgements

The authors acknowledge the contributions of other members of the study team, especially Drs. Jill Owczarzak, Timothy McAuliffe, Laura Bogart, and Jeffrey Kelly. We also thank our staff at the Center for AIDS Intervention Research and our participants who volunteered their time. This work was presented in part at the International Association of Providers of AIDS Care (IAPAC) Conference; June 17–19, 2019; Miami, FL.

Funding

Funding support was provided by Gilead Sciences, Inc. (IN-US-276–0123, PI: Petroll) and the National Institute of Mental Health (P30-MH052776, PI: Kelly; K01-MH118939, PI: John; K01-MH112412, PI: Quinn). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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  1. Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 N. Summit Avenue, Milwaukee, WI, 53202, USA

    Steven A. John, Katherine G. Quinn, Benedikt Pleuhs, Jennifer L. Walsh & Andrew E. Petroll

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  1. Steven A. John
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Correspondence to Steven A. John.

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AEP receives research funding from Gilead Sciences, Inc. All other authors declare that they have no conflict of interest.

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This study met the Medical College of Wisconsin Institutional Review Board’s definition of “minimal risk” and a waiver of informed consent was granted.

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John, S.A., Quinn, K.G., Pleuhs, B. et al. HIV Post-Exposure Prophylaxis (PEP) Awareness and Non-Occupational PEP (nPEP) Prescribing History Among U.S. Healthcare Providers. AIDS Behav 24, 3124–3131 (2020). https://doi.org/10.1007/s10461-020-02866-6

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