A mixed-methods evaluation of an HIV pre-exposure prophylaxis educational intervention for healthcare providers in a NYC safety-net hospital-based obstetrics and gynecology clinic

AIDS Care. 2024 Oct;36(10):1537-1544. doi: 10.1080/09540121.2024.2364218. Epub 2024 Jun 29.

Abstract

Cisgender women and transgender men are less likely to be assessed for PrEP eligibility, prescribed PrEP, or retained in PrEP care. Thus, this pilot PrEP educational intervention was tailored for healthcare providers (HCPs) in obstetrics/gynecology who provide care to cisgender women and transgender men in an academically-affiliated, public hospital women's health clinic. The three-lecture educational curriculum designed for HCPs focused on PrEP eligibility and counseling, formulations and adherence, and prescription and payment assistance programs. Pre- and post-intervention surveys assessed HCP knowledge and barriers to PrEP counseling and prescription. Among n = 49 participants (mean age = 32.8 years; 85.7% cisgender women, mean years practicing = 4.2 years) pre-intervention, 8.7% had prior PrEP training and 61.2% felt very/somewhat uncomfortable prescribing PrEP. Post-intervention, knowledge of PrEP contraindications, eligibility, follow-up care, and assistance programs all increased. HCPs identified key barriers to PrEP care including lack of a dedicated PrEP navigator, culturally and linguistically appropriate patient materials on PrEP resources/costs, and PrEP-related content integrated into EHRs. Ongoing PrEP educational sessions can provide opportunities to practice PrEP counseling, including information on financial assistance. At the institutional level, incorporating PrEP screening in routine clinical practice via EMR prompts, facilitating PrEP medication monitoring, and enhancing telehealth for follow-up care could enhance PrEP prescription.

Keywords: HIV pre-exposure prophylaxis; cisgender women; educational intervention; gynecology; healthcare education; obstetrics.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Counseling
  • Female
  • Gynecology / education
  • HIV Infections* / prevention & control
  • Health Knowledge, Attitudes, Practice
  • Health Personnel* / education
  • Humans
  • Male
  • Middle Aged
  • Obstetrics / education
  • Pilot Projects
  • Pre-Exposure Prophylaxis*
  • Safety-net Providers
  • Surveys and Questionnaires
  • Transgender Persons

Substances

  • Anti-HIV Agents