A Closer Look at Racism and Heterosexism in Medical Students’ Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education

Calabrese, Sarah K.; Earnshaw, Valerie A.; Krakower, Douglas S.; Underhill, Kristen; Vincent, Wilson; Magnus, Manya; Hansen, Nathan B.; Kershaw, Trace; Mayer, Kenneth H.; Betancourt, Joseph R.; Dovidio, John F.

doi:10.1007/s10461-017-1979-z

Cited by 74 publications

(62 citation statements)

References 49 publications

(72 reference statements)

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“…Additionally, graduate medical courses should work to debunk racial and other stereotypes about risk compensation, as such biases impede provider willingness to prescribe PrEP (23)(24)(25)34). Future work could examine the extent to which hands-on experiences with high-risk populations (e.g., via clinical rotations) impact both willingness to prescribe and refer.…”

Section: Interdisciplinary Approaches To Prep Carementioning

confidence: 99%

“…The few studies were limited to medical students (23)(24)(25)(26) and did not include other health professional students who may play an active role in PrEP care, such as those in nurse practitioner, or pharmacy training programs. Calabrese and colleagues surveyed medical students regarding the influence of patient race (23), sexual orientation (24), and sexual behavior (25) on clinical decision-making related to PrEP. Results demonstrate that medical students' awareness of PrEP was generally high (85%), with half reporting PrEP education during medical school.…”

Section: Introductionmentioning

confidence: 99%

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HIV Pre-Exposure Prophylaxis (PrEP) Knowledge, Familiarity, and Attitudes among Healthcare Professional Students

Przybyla¹,

Fillo²,

Kamper‐DeMarco³

et al. 2019

Preprint

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Background The federal government’s plan to End the HIV Epidemic by 2030 includes a primary goal to reduce new HIV infections by 90 percent. One key contributor to this plan is pre-exposure prophylaxis (PrEP), a medication taken by HIV-uninfected individuals to prevent infection. While knowledge and acceptance of PrEP among clinicians is growing, few studies have assessed knowledge and awareness among future healthcare professionals in academic training programs. Given the limited research on PrEP among healthcare professional students, a better understanding of knowledge and familiarity with PrEP prescription may inform the development of educational interventions targeting this population in an effort to increase implementation. The present study aimed to assess and compare healthcare trainees’ PrEP awareness, knowledge, and familiarity with prescription guidelines with a broad goal to better understand and prevent gaps in academic training regarding PrEP. Methods A cross-sectional web-based survey of medical, nurse practitioner, and pharmacy students enrolled at two universities was conducted between October 2017-January 2018. The study assessed participants’ awareness, knowledge, and familiarity with PrEP prescribing guidelines and willingness to prescribe PrEP and refer to another healthcare provider. Results The survey was completed by 744 participants (overall response rate = 36.2%). There were significant differences among student groups in all domains. Pharmacy students had the greatest PrEP knowledge, awareness, and familiarity with prescribing guidelines. However, medical students reported the greatest comfort with performing PrEP-related clinical activities and willingness to refer a candidate to another provider. Greater familiarity with PrEP prescription guidelines was associated with willingness to prescribe the medication. Conclusions Healthcare professional students’ responses enhance our understanding of the relevant experiences and perspectives of future healthcare providers that influence their knowledge towards the promotion of PrEP through prescription and referral intentions. The gaps in students’ knowledge offer opportunities for the development of educational strategies to support HIV prevention among future healthcare professionals.

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Section: Interdisciplinary Approaches To Prep Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HIV Pre-Exposure Prophylaxis (PrEP) Knowledge, Familiarity, and Attitudes among Healthcare Professional Students

Przybyla¹,

Fillo²,

Kamper‐DeMarco³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Therefore, they need to address stigma associated with HIV/AIDS and MSM as major factors in the training of future health professionals. This stigma related training should not be supplemental to their usual curricula, but rather as a central aspect of physician/patient interaction training which is required of medical schools (Calabrese et al, 2018;Varas-Díaz et al, 2017). The ongoing HIV/AIDS epidemic among MSM, and the concerns over stigma manifestations during clinical interactions, highlight the importance of medical schools as important scenarios for stigma reduction training.…”

Section: Resultsmentioning

confidence: 99%

HIV/AIDS stigma manifestations during clinical interactions with MSM in Puerto Rico

Varas-Díaz

Rivera-Segarra

Neilands

et al. 2019

Journal of Gay & Lesbian Social Services

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“…In several studies, researchers found that implicit racist and homophobic biases among health care providers may limit access to PrEP among those patients most in need. A study among medical students found that a prevention paradox in their lack of willingness to prescribe PrEP was inconsistent with patient risk and may have been impacted by implicit racial bias (171). Using data from the Urban Men's Health Study, another study found that the combination that racism and minority sexual orientation status has impacts on Black MSM's encountered everyday racism, and thus Black MSM have a less positive experience with the gay community than their White counterparts (172).…”

Section: Homophobia and Racism: Being A Black Gay Or Bisexual Manmentioning

confidence: 99%

Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean

Taylor

DeHovitz

Hirshfield

2020

Front. Public Health

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Testing is the entry point into the HIV care continuum that includes linkage to and retention in prevention services, and adherence to prevention strategies, including repeat HIV testing. Despite US policy approaches to expand HIV testing to diverse clinical care and community settings, disparities in HIV testing among Black populations persist. Foreign-born (FB) Black persons from the Caribbean have higher annual rates of HIV diagnosis and a higher percentage of late-stage HIV diagnosis, compared with US-born Black persons; and most HIV infections among FB Blacks are among men. In this article, we provide an overview of HIV testing barriers among FB Black men who engage in HIV risk-taking behaviors (e.g., condomless sex with male and/or female partners of unknown HIV serostatus). Barriers to HIV testing for both FB and US-born Black men, include HIV stigma (anticipated, perceived, internalized), low perceived HIV risk, medical or government mistrust, and perceived low access to testing resources. We examine beliefs about masculinity and gender roles that may perpetuate heteronormative stereotypes associated with perceptions of low HIV risk and barriers to HIV testing. We also discuss the impact of recent immigration policies on accessing HIV testing and treatment services and how intersectional stigmas and structural forms of oppression, such as racism, prejudice against select immigrant groups, and homophobia that may further amplify barriers to HIV testing among FB Black men. Finally, we review comprehensive prevention approaches, and suggest innovative approaches, that may improve the uptake of HIV testing among FB Black men.

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A Closer Look at Racism and Heterosexism in Medical Students’ Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education

Cited by 74 publications

References 49 publications

HIV Pre-Exposure Prophylaxis (PrEP) Knowledge, Familiarity, and Attitudes among Healthcare Professional Students

HIV Pre-Exposure Prophylaxis (PrEP) Knowledge, Familiarity, and Attitudes among Healthcare Professional Students

HIV/AIDS stigma manifestations during clinical interactions with MSM in Puerto Rico

Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean

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