Enhancing HIV Pre-exposure Prophylaxis Practices via an Educational Intervention

Newman, Rebecca; Katchi, Tasleem; Karass, Michael; Gennarelli, Melissa; Goutis, Jason; Kifayat, Alina; Solanki, Shantanu; Yandrapalli, Srikanth; Leanne, F; Nabors, Christopher

doi:10.1097/mjt.0000000000000773

Cited by 17 publications

(17 citation statements)

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“…Similar findings were reported in a survey of internal medicine residents (N = 48), of whom 22% were unaware of PrEP and 62% had fair or poor awareness of side effects. PrEP was considered effective or safe by only 78% or 66% of participants, respectively [98].…”

Section: Side Effects/medication Interaction Concerns As a Barrier Tomentioning

confidence: 99%

“…Counseling on the benefits of PrEP, and providing information and reassurance on the risk and monitoring of short-and long-term side effects, may also improve adherence to PrEP [119]. It is also imperative that educational interventions are targeted to primary care providers, including training to increase PrEP knowledge [120] and to alleviate concerns regarding PrEP safety [98]. Concerns around risk compensation (or an increase in risk-taking behaviors among individuals at risk prompted by a decrease in perceived HIV risk) appear to be one factor that can cause reluctance among some healthcare providers to prescribe PrEP to eligible patients [53].…”

Section: Potential Solutions To Barriersmentioning

confidence: 99%

“…Education targeted to primary care providers has been shown to be effective: after an educational intervention, the proportion of participants (internal medicine residents) who believed PrEP was safe increased from 66% to 92% and the proportion who believed it was effective increased from 78% to 94%. Before training, only one-third of participants were likely to prescribe PrEP in the next 6 months, which increased to two-thirds after training [98]. Healthcare professionals wishing to prescribe PrEP and who want to learn more about its implementation can refer to current CDC/US Public Health Service (USPHS) clinical guidelines for comprehensive information on the use of daily oral antiretroviral PrEP to reduce the risk of acquiring HIV infection in adults [33].…”

Section: Potential Solutions To Barriersmentioning

confidence: 99%

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Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

2020

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Antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV transmission was first approved by the US Food and Drug Administration in 2012. Despite correlations of decreases in new HIV infections being greatest where PrEP has been deployed, the uptake of PrEP is lagging, particularly among populations with disproportionate HIV burden. This narrative review seeks to identify individual and systemic barriers to PrEP usage in the USA. A comprehensive search of recent literature uncovered a complex array of structural, social, clinical, and behavioral barriers, including knowledge/awareness of PrEP, perception of HIV risk, stigma from healthcare providers or family/partners/friends, distrust of healthcare providers/systems, access to PrEP, costs of PrEP, and concerns around PrEP side effects/medication interactions. Importantly, these barriers may have different effects on specific populations at risk. The full potential of PrEP for HIV prevention will not be realized until these issues are addressed. Strategies to achieve this goal should include educational interventions, innovative approaches to delivery of HIV care, financial support, and destigmatization of PrEP and PrEP users. Until then, PrEP uptake will continue to be suboptimal, particularly among those who need it most.

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Section: Side Effects/medication Interaction Concerns As a Barrier Tomentioning

confidence: 99%

Section: Potential Solutions To Barriersmentioning

confidence: 99%

Section: Potential Solutions To Barriersmentioning

confidence: 99%

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Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

2020

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“…Given the central role of lay HIV workers in PrEP implementation, it is critical to understand their implementation behaviors related to PrEP. Unlike previous evaluation of PrEP trainings that primarily focused on investigating whether the trainings had any effects on trainees' knowledge [15,18,20], confidence of [18][19][20] and comfort level in discussing PrEP with clients [16], we systematically assessed determinants of implementation behavior through a valid and reliable questionnaire (DIBQ) [47,48]. We observed a positive influence of the training on almost all DIBQ domains, suggesting the training's potential in mobilizing and motivating lay HIV workers to participate in upcoming PrEP implementation in China.…”

Section: Discussionmentioning

confidence: 99%

“…Training lay HIV workers is therefore a critical implementation strategy for PrEP [14]; evaluating such trainings is necessary to generate evidence on effective and efficient approaches to build capacity of lay HIV workers to support PrEP implementation. Previous published studies of PrEP capacity building efforts have reported on training of internal medicine residents [15,16], primary care providers [17], family planning providers [18], and the whole HIV care team [19,20]. To our knowledge, there is no published data on approaches to and evaluation of trainings that specifically target lay HIV workers to facilitate PrEP implementation.…”

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confidence: 99%

Acceptability, Appropriateness, and Preliminary Effects of the PrEP Diffusion Training for Lay HIV Workers: Increased PrEP Knowledge, Decreased Stigma, and Diffusion of Innovation

Ye²,

Meyers³

2020

Preprint

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Background Training lay health workers is a critical strategy for HIV pre-exposure prophylaxis (PrEP) implementation, but little is known about effective approaches to conducting and evaluating such trainings. We evaluated the effect of the PrEP Diffusion Training, a one-day participatory training informed by the Diffusion of Innovation theory, on knowledge, PrEP stigma, implementation behavior, and diffusion of PrEP innovation among lay HIV workers in China.Methods Nine PrEP Diffusion Trainings were delivered to 220 lay HIV workers. We conducted multi-time-point surveys to assess acceptability, appropriateness, and preliminary effects of the training on participants’ knowledge, PrEP stigma, determinants of implementation behavior, and diffusion of PrEP information. We used an observation-based checklist to evaluate implementation fidelity.Results All trainings were delivered with high fidelity to the standardized manual, with little variability across sites. Acceptability and appropriateness of training were high. PrEP knowledge score significantly increased by 65% from pre-training to post-training, and remained high one month after the training. We observed a significant decrease in PrEP stigma and a positive influence on determinants of implementation behaviors. All participants surveyed one-month after the training reported having shared PrEP information in their social networks, and 43% reported integrating PrEP education into their routine HIV prevention work on a regular basis.Conclusions The PrEP Diffusion Training is a practical and effective strategy to build lay HIV workers’ capacity to participate in PrEP implementation. Longer-term follow up post training would be ideal to further assess actual PrEP uptake and sustained effects of intervention on PrEP implementation.

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Acceptability, Appropriateness, and Preliminary Effects of the PrEP Diffusion Training for Lay HIV Workers: Increased PrEP Knowledge, Decreased Stigma, and Diffusion of Innovation

Yang²,

Meyers

2021

AIDS Behav

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Background Training lay health workers is a critical strategy for HIV pre-exposure prophylaxis (PrEP) implementation, but little is known about effective approaches to conducting and evaluating such trainings. We evaluated the effect of the PrEP Diffusion Training, a one-day participatory training informed by the Diffusion of Innovation theory, on knowledge, PrEP stigma, implementation behavior, and diffusion of PrEP innovation among lay HIV workers in China. Methods Nine PrEP Diffusion Trainings were delivered to 220 lay HIV workers. We conducted multi-timepoint surveys to assess acceptability, appropriateness, and preliminary effects of the training on participants' knowledge, PrEP stigma, determinants of implementation behavior, and diffusion of PrEP information. We used an observation-based checklist to evaluate implementation delity. Results All trainings were delivered with high delity to the standardized manual, with little variability across sites. Acceptability and appropriateness of training were high. PrEP knowledge score signi cantly increased by 65% from pre-training to post-training, and remained high one month after the training. We observed a signi cant decrease in PrEP stigma and a positive in uence on determinants of implementation behaviors. All participants surveyed one-month after the training reported having shared PrEP information in their social networks, and 43% reported integrating PrEP education into their routine HIV prevention work on a regular basis. Conclusions The PrEP Diffusion Training is a practical and effective strategy to build lay HIV workers' capacity to participate in PrEP implementation. Longer-term follow up post training would be ideal to further assess actual PrEP uptake and sustained effects of intervention on PrEP implementation.

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Enhancing HIV Pre-exposure Prophylaxis Practices via an Educational Intervention

Abstract: Brief, focused training on HIV prevention promotes awareness, acceptance, and likelihood of prescribing PrEP by internal medicine trainees.

Cited by 17 publications

References 8 publications

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

Acceptability, Appropriateness, and Preliminary Effects of the PrEP Diffusion Training for Lay HIV Workers: Increased PrEP Knowledge, Decreased Stigma, and Diffusion of Innovation

Acceptability, Appropriateness, and Preliminary Effects of the PrEP Diffusion Training for Lay HIV Workers: Increased PrEP Knowledge, Decreased Stigma, and Diffusion of Innovation

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