Uptake of preexposure prophylaxis (PrEP) has been slow, but is increasing. Although PrEP is indicated for many patients, it has been concentrated among men who have sex with men (MSM). Awareness of PrEP is limited among non-MSM individuals, and among some MSM. As such, individuals at risk for HIV who are unaware of PrEP must rely on their medical providers to initiate conversations about PrEP. Members of a national professional organization of HIV specialists with prescribing privileges, including physicians, nurse practitioners, and physician assistants, participated in an online survey (n = 342) to characterize their PrEP prescribing behaviors and the demographic membership of their PrEP patients. Results indicated that when discussing PrEP with their patients, providers who more frequently initiated these conversations had a higher percentage of non-MSM patients in their PrEP caseload (e.g., women, people who inject drugs, transgender patients). Encouraging providers to initiate discussions about PrEP with their patients and helping them locate support to offset the cost may help increase uptake, particularly among at-risk patients who are underrepresented in PrEP adoption.
AdamsL. M.BaldersonB. H. (2016). HIV providers’ likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: A short report. AIDS Care, 28, 1154-1158. doi:10.1080/09540121.2016.1153595.
2.
AuerbachJ. D.KinskyS.BrownG.CharlesV. (2015). Knowledge, attitudes, and likelihood of pre-exposure prophylaxis (PrEP) use among US women at risk of acquiring HIV. AIDS Patient Care & STDs, 29, 102-110.
3.
BaetenJ. M.DonnellD.NdaseP.MugoN. R.CampbellJ. D.WangisiJ.. . . CelumC. (2012). Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. New England Journal of Medicine, 367, 399-410.
4.
BushS.MagnusonD.RawlingsM. K.HawkinsT.McCallisterS.Mera GilerR. (2016, June). Racial characteristics of FTC/TDF for pre-exposure prophylaxis (PrEP) users in the US. Paper presented at the meeting of the American Society for Microbiology Interscience Conference on Antimicrobial Agents and Chemotherapy, Boston, MA.
5.
BushS.NgL.MagnusonD.PiontkowskyD.Mera GilerR. (2015, June). Significant uptake of Truvada for pre-exposure prophylaxis (PrEP) utilization in the US in late 2014-1q2015. Paper presented at the meeting of the International Association of Providers of AIDS Care, Miami, FL.
6.
CalabreseS. K.KrakowerD. S.MayerK. H. (2017). Integrating HIV preexposure prophylaxis (PrEP) into routine preventive health care to avoid exacerbating disparities. American Journal of Public Health, 107, 1883-1889.
7.
CalabreseS. K.MagnusM.MayerK. H.KrakowerD. S.EldahanA. I.Gaston HawkinsL. A.. . . DovidioJ. F. (2016). Putting PrEP into practice: Lessons learned from early adopting U.S. providers’ firsthand experiences providing HIV pre-exposure prophylaxis and associated care. PLoS One, 11, e0157324. doi:10.1371/journal.pone.0157324
8.
Centers for Disease Control and Prevention. (2012, December13). 2011 Sexually transmitted diseases surveillance: Census regions in the United States. Retrieved from https://www.cdc.gov/std/stats11/census.htm
9.
Centers for Disease Control and Prevention. (2014, May14). Preexposure prophylaxis for the prevention of HIV infection in the United States—2014 Clinical Practice Guideline. Retrieved from http://www.cdc.gov/hiv/pdf/prepguidelines2014.pdf
10.
ConniffJ.EvensenA. (2016). Preexposure prophylaxis (PrEP) for HIV prevention: The primary care perspective. Journal of the American Board of Family Medicine, 29, 143-151.
11.
EatonL. A.DriffinD. D.BauermeisterJ.SmithH.Conway-WashingtonC. (2015). Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, Black men who have sex with men. AIDS Patient Care & STDs, 29, 423-429.
12.
EdelmanE. J.MooreB. A.CalabreseS. K.BerkenblitG.CunninghamC.PatelV.. . . BlackstockO. (2017). Primary care physicians’ willingness to prescribe HIV pre-exposure prophylaxis for people who inject drugs. AIDS and Behavior, 21, 1025-1033.
13.
ElopreL.KudroffK.WestfallA. O.OvertonE. T.MugaveroM. J. (2017). The right people, right places, and right practices: Disparities in PrEP access among African American men, women, and MSM in the deep south. Journal of Acquired Immune Deficiency Syndrome, 74, 56-59.
14.
EscuderoD. J.KerrT.WoodE.NguyenP.LurieM. N.SuedO.MarshallB. D. L. (2015). Acceptability of HIV pre-exposure prophylaxis (PrEP) among people who inject drugs (PWID) in a Canadian setting. AIDS and Behavior, 19, 752-757.
15.
FlashC.LandovitzR.Mera GilerR.NgL.MagnusonD.Bush WooleyStRawlingsK. (2014). Two years of Truvada for pre-exposure prophylaxis utilization in the US. Journal of the International AIDS Society, 17(4Suppl. 3), 19730.
16.
FonnerV. A.DalglishS. L.KennedyC. E.BaggaleyR.O’ReillyK. R.KoechlinF. M.. . . GrantR. M. (2016). Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS, 30, 1973-1983.
17.
GrantR. M.AndersonP. L.McMahanV.LiuA.AmicoK. R.MehrotraM.. . . GliddenD. V. (2014). Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet, 14, 820-829.
18.
GrantR. M.LamaJ. R.AndersonP. L.McMahanV.LiuA. Y.VargasL.. . . GliddenD. V. (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine, 363, 2587-2599.
19.
IBM Corporation. (2013). IBM SPSS Statistics for Windows (version 22.0) [Computer software]. Armonk, NY: Author.
20.
KarrisM. Y.BeekmannS. E.MehtaS. R.AndersonC. M.PolgreenP. M. (2014). Are we prepped for preexposure prophylaxis (PrEP)? Provider opinions on the real-world use of PrEP in the United States and Canada. Clinical Infectious Diseases, 58, 704-712. doi:10.1093/cid/cit796
21.
KrakowerD. S.BeekmanS. E.PolgreenP. M.MayerK. H. (2016). Diffusion of newer HIV prevention innovations: Variable practices of frontline infectious diseases physicians. Clinical Infectious Diseases, 62, 99-105. doi:10.1093/cid/civ736.
22.
KrakowerD. S.MayerK.H. (2016). The role of healthcare providers in the roll out of preexposure prophylaxis. Current Opinion in HIV/AIDS, 11, 41-48.
23.
KrakowerD. S.OldenburgC. E.MittyJ. A.WilsonI. B.KurthA. E.MaloneyK. M.. . . MayerK.H. (2015). Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention: Results from a survey of healthcare providers in New England. PLoS One, 10, e0132398.
24.
Mera GilerR.MagnusonD.TrevorH.BushS.RawlingsK.McCallisterS. (2017, July). Changes in Truvada (TVD) for HIV pre-exposure prophylaxis (PrEP) utilization in the United States (2012-2016). Paper presented at the 9th International AIDS Society Conference on HIV Science, Paris, France.
25.
PetrollA. E.WalshJ. L.OwczarzakJ. L.McAuliffeT. L.BogartL. M.KellyJ.A. (2017). PrEP awareness, familiarity, comfort, and prescribing experience among US primary care providers and HIV specialists. AIDS and Behavior, 21, 1256-1267.
26.
SmithD. K.van HandelM.WolitskiR. J.StrykerJ. E.HallI.PrejeanJ.. . . ValleroyL. A. (2015). Estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR Morbidity and Mortality Weekly Report, 64, 1291-1295.
27.
ThigpenM. C.KebaabetsweP. M.PaxtonL. A.SmithD. K.RoseC. E.SegolodiT. M.. . . BrooksJ. T. (2012). Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. New England Journal of Medicine, 367, 423-434.
28.
WalkerD.FridericiJSkiestD. (2017). Primary care providers have limited knowledge about STI screening and HIV PrEP in men who have sex with men. Open Forum Infectious Diseases, 4(Suppl 1), S667.
WuH.MendozaM. C. B.HuangY. A.HayesT.SmithD. K.HooverK. H. (2017). Uptake of HIV preexposure prophylaxis among commercially insured persons—United States, 2010-2014. Clinical Infectious Disease, 64, 144-149.
