Brief Report: Impact of PrEP Training for Family Planning Providers on HIV Prevention Counseling and Patient Interest in PrEP in Atlanta, Georgia

Abstract

Background: Safety net family planning (FP) clinics provide vital care for women in high HIV-burden areas and may be ideal pre-exposure prophylaxis (PrEP) delivery sites. Yet, many FP providers lack knowledge about PrEP. Setting: Four safety net FP clinics in Atlanta, Georgia. Methods: We provided a 1.5-hour PrEP informational training for 28 providers working in these sites. To assess the training's impact on PrEP counseling, we enrolled 500 female patients after training (47% ≤ 28 years; 69% black; 12% Hispanic) and determined their PrEP indication based on CDC guidelines. We conducted a postvisit survey to assess provider counseling and patients' interest in PrEP and acceptance of off-site PrEP referral. Results: From pre-training to post-training, provider PrEP knowledge and confidence to identify women who may benefit from PrEP significantly increased. Only 19% of women knew about PrEP before the visit. Among 376 sexually active women, 29% had risk consistent with PrEP indication. Among PrEP-indicated women, 66% reported the provider discussed PrEP, 29% were interested in taking PrEP, but only 18% accepted off-site PrEP referral. Most (76%) were more willing to take PrEP if provided by the FP clinic. Conclusions: After a brief PrEP training, most women with HIV-risk indicators received PrEP counseling during their visits. Once counseled, women expressed interest if it were offered at the FP clinic rather than through off-site referral. Findings highlight the potential impact that PrEP capacity building within safety net FP clinics in high HIV-burden areas may have on PrEP scale-up for women.

Exploring the heterogeneity of factors that may influence implementation of PrEP in family planning clinics: a latent profile analysis

“…However, we suggest that all clinics, prior to PrEP implementation, receive a training on the process for conducting the PrEP cascade (i.e., HIV risk assessment, PrEP patient education, assessing patient eligibility for PrEP, PrEP prescription, and PrEP follow-up care) to ensure that clinic staff, providers, and administrators are informed of necessary requirements. We have previously shown that a 1 hour training is able to significantly increase providers’ PrEP knowledge, attitudes, and skills [ 49 ].…”

Knowledge needs for implementing HIV pre-exposure prophylaxis among primary care providers in a safety-net health system

“…For example, the characteristics of providers and settings, measurement of PrEP knowledge, and covariates selected for adjustment to reduce confounding bias varied across studies. Nevertheless, evidence from intervention studies supports the idea that improving PrEP knowledge can increase PrEP adoption and prescribing among PCPs ( Bunting et al, 2020 , Clement et al, 2018 , Sales et al, 2019 ).…”

Optimizing Provider Preexposure Prophylaxis (PrEP) Training: A Cross-Sectional Analysis of Recommendations from Providers Across the PrEP Implementation Cascade

“…For example, the AIDS Education and Training Center’s (AETC) National HIV Curriculum provides self-guided PrEP training modules for continuing education credits that cover basic information about PrEP clinical guidelines, skills for initiating and monitoring, PrEP efficacy and clinical trial evidence, and potential risks and side effects [ 18 ]. Another recent PrEP training program for family planning providers covered information related to HIV epidemiology and prevention, patient risk assessment and referral, and example case scenarios [ 19 ]. Finally, the Training and Technical Assistance Program (T-TAP) in New York City offers several day-long PrEP trainings on various subjects, including the basics of PrEP, best practices in PrEP education and counseling, and financial barriers and benefits navigation for PrEP [ 20 ].…”