PrEP (Pre-Exposure Prophylaxis) Education for Clinicians: Caring for an MSM Patient

Abstract

Introduction: Gaps exist in educational materials addressing LGBTQ patient care and LGBTQ health. One such area is prescribing HIV pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM). PrEP awareness, familiarity, and comfort in prescribing are very important in the rollout and success of PrEP as a preventative measure. Our needs assessments showed a lack of familiarity and comfort among clinicians/medical students in prescribing PrEP. Furthermore, studies have shown that since its launch as an effective prevention method of HIV transmission, PrEP has not been widely prescribed to at-risk populations. Educating clinicians about PrEP may increase its use among high-risk MSM populations and reduce the incidence of HIV infections. Methods: For medical students, we developed a didactic presentation and video recording discussing (1) a brief history of HIV prevention, (2) indications for PrEP prescription, (3) medical testing for PrEP onboarding, (4) common PrEP side effects, and (5) appropriate follow-up and testing for PrEP maintenance and discontinuation. We also developed a videotaped clinical encounter demonstrating communication skills used in PrEP counseling. Preand postworkshop surveys assessed participants' PrEP attitudes and knowledge. Results: All 43 survey respondents were secondthrough fourth-year medical students. Pre-and postpresentation evaluation of questions assessing comfort demonstrated a statistically significant improvement in level of comfort with understanding when to prescribe PrEP and in level of knowledge in prescribing PrEP. Discussion: Workshop participants acknowledged their training gaps in PrEP prescribing and acquired knowledge and comfort with prescribing PrEP for at-risk populations.

LGBTQ+ health education for medical students in the United States: a narrative literature review

“…This included 2 required pre-clinical interventions and 4 elective interventions that either took place throughout both parts of the curriculum or it was unclear when they took place. While not all studies discussed statistical significance, among these interventions that focused on HIV and PrEP, 2 studies demonstrated significantly increased knowledge on this topic [ 23 , 91 ], 1 study found significantly increased agreement or confidence in some learning objectives at one site in the study [ 79 ], and 1 study found significantly increased comfort discussing sexual behaviors with men who have sex with men (MSM), identifying at-risk MSM who may benefit from PrEP, and prescribing PrEP to MSM [ 91 ].…”

The Role of Social Biases, Race, and Condom Use in Willingness to Prescribe HIV Pre-exposure Prophylaxis to MSM: An Experimental, Vignette-Based Study

“…50,52 Although there is a growing body of literature investigating PrEP education in medical school curricula, few resources exist for improving PrEP education. 32,[53][54][55][56] As future physicians, training medical students with the tools to address the need for improved access to biomedical HIV prevention strategies, like PrEP, in a patient-centered way will be necessary in the ongoing efforts to end the HIV epidemic in the United States.…”

Knowledge of HIV and HIV pre-exposure prophylaxis among medical and pharmacy students: A national, multi-site, cross-sectional study

“…There are published resources describing PrEP training interventions, including a case-based training module for clinicians about HIV risk assessment, PrEP prescription, and management for an MSM patient as well as a guide for development of interprofessional, clinician training about PrEP ( Bunting et al, 2019 , Perucho et al, 2020 ). These resources may be directly adapted to medical or pharmacy education.…”