Only approximately 54% of medical practitioners say they have prescribed pre-exposure prophylaxis (PrEP) to HIV-vulnerable patients, according to a new study published in PLOS ONE.

PrEP is a once-daily medication for people without HIV and is widely accepted as an effective method of preventing transmission of the virus, according to the study. However, less than 10% of the more than 1 million people vulnerable to HIV take PrEP, the study authors said. 

It is necessary for PrEP to be made accessible to as many people as possible if the United States is to meet its policy goal of eradicating HIV by 2030, the researchers noted. The study, which was conducted by Vanderbilt University Medical Center, assessed 519 practitioners in 5 major US cities who attended a continuing education course on HIV between March and May 2015. 

Internal medicine prescribers were 1.6 times more likely to prescribe PrEP than infectious disease practitioners, according to the study. Investigators suggest that this is an indicator of how important internal and family medicine practitioners are in assessing and mitigating patient risk. 

The slow adoption of PrEP among certain practitioners may be due to the longstanding confusion and disagreement between HIV and primary care practitioners over who should be responsible for prescribing preventive medication, according to the study. 

"While a number of factors could impact PrEP prescribing, including patients' low familiarity with the drug or practitioners' lack of opportunity in offering PrEP, in order for the drug to be effective at eliminating HIV in the United States in the next 10 years, the proportion of prescribing needs to increase, with more effort placed on identifying risk across populations and clinical specialties," Ashley Leech, PhD, assistant professor of health policy at Vanderbilt University, said in a press release. 

Internal medicine versus infectious disease practitioners were not the only factors that went into PrEP prescribing habits. Age, years of training, and sex were all factors associated with prescribing experience. 

Additionally, the study found that practitioners may be more willing to prescribe PrEP to individuals who inject drugs than previously believed. More research is still needed, however, to communicate with at-risk groups, according to the study.  

Reference:
Many practitioners are not prescribing HIV prevention medication [News Release]. September 17, 2020. Nashville, TN. https://www.sciencedaily.com/releases/2020/09/200917181238.htm. Accessed September 22, 2020.