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Interprofessional Collaboration Improves the Odds of Educating Patients About PrEP over Time

Abstract

Background

Low levels of pre-exposure prophylaxis (PrEP) uptake continue among the most vulnerable (e.g., men who have sex with men) for HIV exposure in the USA. Providers of social and public health services (“psychosocial providers”) can help improve this situation by educating patients about PrEP before linking them to primary care providers (PCPs).

Objective

To identify predictors of psychosocial providers offering PrEP education to patients vulnerable to HIV infection by determining the frequency with which psychosocial providers offer PrEP education to patients.

Design

Longitudinal overview of PrEP implementation in New York City.

Participants

Psychosocial providers of HIV prevention and adjunct treatment services, such as medication adherence counseling in 34 community settings.

Main Measures

Longitudinal survey data collected in 2014–2016 (baseline) and 2015–2017 (1-year follow-up) from a 5-year longitudinal repeated measures study. Logistic regression modeling tested associations between baseline psychosocial provider-level and organization-level characteristics and frequency of PrEP education at baseline and 1-year follow-up.

Key Results

Out of 245 participants, the number of psychosocial providers offering PrEP education at least once in the past 6 months increased significantly from baseline (n = 127, 51.8%) to 1-year follow-up (n = 161, 65.7%). Participants with higher odds of offering PrEP education at baseline and at one1-year follow-up were more likely to have reported high levels of interprofessional collaboration (IPC) and were also more likely to have received formal HIV prevention training.

Conclusions

Both IPC and HIV training are predictive of PrEP education, and this association was maintained over time. We recommend expanding educational outreach efforts to psychosocial providers to further improve PrEP education and also training in interprofessional collaboration. This is an important first step toward linking patients to PCPs who prescribe PrEP and may help improve PrEP uptake.

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References

  1. 1.

    Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med 2010; 363:2587–99.

  2. 2.

    Donnell D, Baeten JM, Bumpus NN, Brantley J, Bangsberg DR, Haberer JE, et al. HIV protective efficacy and correlates of tenofovir blood concentrations in a clinical trial of PrEP for HIV prevention. J Acquir Immune Defic Syndr 2014; 66:340–8.

  3. 3.

    Anderson PL, Glidden DV, Liu A, Buchbinder S, Lama JR, Guanira JV, et al. Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Sci Transl Med. 2012; 4:151ra25.

  4. 4.

    Thomson KA, Baeten JM, Mugo NR, Bekker LG, Celum CL, Heffron R. Tenofovir-based oral preexposure prophylaxis prevents HIV infection among women. Curr Opin HIV AIDS 2016; 11:18–26.

  5. 5.

    Petroll AE, Walsh JL, Owczarzak JL, McAuliffe TL, Bogart LM, Kelly JA. PrEP Awareness, Familiarity, Comfort, and Prescribing Experience among US Primary Care Providers and HIV Specialists. AIDS Behav 2017; 21:1256–67.

  6. 6.

    Wilton J, Senn H, Sharma M, Tan DH. Pre-exposure prophylaxis for sexually-acquired HIV risk management: a review. HIV AIDS (Auckl). 2015; 7:125–36.

  7. 7.

    Centers for Disease Control and Prevention. HIV Infection Risk, Prevention, and Testing Behaviors Among Men Who Have Sex With Men—National HIV Behavioral Surveillance, 23 U.S. Cities, 2017. 2019; Available from: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-special-report-number-22.pdf.

  8. 8.

    Pinto R, Witte SS, Filippone PL, Choi CJ, Wall M. Policy Interventions Shaping HIV Prevention: Providers’ Active Role in the HIV Continuum of Care. Health Educ Behav 2018; 45:714–22.

  9. 9.

    Krakower DS, Mimiaga MJ, Rosenberger JG, Novak DS, Mitty JA, White JM, et al. Limited Awareness and Low Immediate Uptake of Pre-Exposure Prophylaxis among Men Who Have Sex with Men Using an Internet Social Networking Site. PLoS One 2012; 7:e33119.

  10. 10.

    Liu AY, Kittredge PV, Vittinghoff E, Raymond HF, Ahrens K, Matheson T, et al. Limited knowledge and use of HIV post- and pre-exposure prophylaxis among gay and bisexual men. J Acquir Immune Defic Syndr 2008; 47:241–7.

  11. 11.

    Krakower D, Ware N, Mitty JA, Maloney K, Mayer KH. HIV providers’ perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav 2014; 18:1712–21.

  12. 12.

    Silapaswan A, Krakower D, Mayer KH. Pre-Exposure Prophylaxis: A Narrative Review of Provider Behavior and Interventions to Increase PrEP Implementation in Primary Care. J Gen Intern Med 2017; 32:192–8.

  13. 13.

    Adams LM, Balderson BH, Brown K, Bush SE, Packett BJ, 2nd. Who Starts the Conversation and Who Receives Preexposure Prophylaxis (PrEP)? A Brief Online Survey of Medical Providers’ PrEP Practices. Health Educ Behav 2018; 45:723–9.

  14. 14.

    Pinto RM, Witte SS, Wall MM, Filippone PL. Recruiting and retaining service agencies and public health providers in longitudinal studies: Implications for community-engaged implementation research. Methodol Innov 2018; 11:2059799118770996.

  15. 15.

    Pinto RM, Spector AY, Rahman R, Gastolomendo JD. Research advisory board members’ contributions and expectations in the USA. Health Promot Int 2015; 30:328–38.

  16. 16.

    Pinto RM, Spector AY, Valera PA. Exploring group dynamics for integrating scientific and experiential knowledge in Community Advisory Boards for HIV research. AIDS Care 2011; 23:1006–13.

  17. 17.

    Bronstein LR. Index of interdisciplinary collaboration. Soc Work Res 2002; 26:113.

  18. 18.

    Pinto RM, Choi J, Wall M. Developing a Scale to Measure Interprofessional Collaboration in HIV Prevention and Care: Implications for Research on Patient Access and Retention in the HIV Continuum of Care. Under review

  19. 19.

    Calabrese SK, Magnus M, Mayer KH, Krakower DS, Eldahan AI, Gaston Hawkins LA, et al. Putting PrEP into Practice: Lessons Learned from Early-Adopting U.S. Providers’ Firsthand Experiences Providing HIV Pre-Exposure Prophylaxis and Associated Care. PLoS One. 2016; 11:e0157324.

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Author information

Correspondence to Rogério M. Pinto PhD.

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The authors declare that they do not have a conflict of interest.

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Cite this article

Pinto, R.M., Kay, E.S., Wall, M.M. et al. Interprofessional Collaboration Improves the Odds of Educating Patients About PrEP over Time. J GEN INTERN MED (2020). https://doi.org/10.1007/s11606-019-05616-0

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KEY WORDS

  • pre-exposure prophylaxis (PrEP)
  • service providers
  • HIV Continuum of Care
  • interprofessional collaboration