Abstract
IntroductionGaps 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.MethodsFor 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. Pre- and postworkshop surveys assessed participants’ PrEP attitudes and knowledge.ResultsAll 43 survey respondents were second- through 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.DiscussionWorkshop participants acknowledged their training gaps in PrEP prescribing and acquired knowledge and comfort with prescribing PrEP for at-risk populations.
Highlights
Gaps exist in educational materials addressing LGBTQ patient care and LGBTQ health
Time Line The suggested length of the workshop is approximately 60 minutes, with a time line suggested below: r Preworkshop evaluation (5 minutes). r Slides 1-38: in-person PPT presentation (25 minutes) or audio-guided PPT presentation (17 minutes). r Videotaped scripted clinical encounter (15 minutes). r Postworkshop evaluation (5 minutes). r Question-and-answer period (10 minutes). This workshop was implemented at two sites: Rutgers New Jersey School of Medicine and Memorial Sloan Kettering Cancer Center (MSKCC)
In our first iteration of the pre-exposure prophylaxis (PrEP) presentation, we did not include a videotaped scripted clinical encounter demonstrating clinical communication skills used for the assessment of risk factors associated with HIV transmission and PrEP counseling
Summary
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). Pre-exposure prophylaxis (PrEP), which uses antiretroviral medications, is an evidencebased preventative strategy shown to prevent new infection among individuals at greatest risk, such as MSM.[3,4,5] Studies have shown that among those who are adherent, PrEP, which uses the drugs tenofovir disoproxil fumarate and emtricitabine, can reduce the risk of HIV transmission by more than 90%.6-8 Even with such a dramatic reduction in risk, PrEP is not widely prescribed.[9] One of the many reasons for this is physicians’ lack of awareness recognizing at-risk populations, as well as their lack of comfort and experience prescribing PrEP.[10] Physicians need to build awareness of at-risk populations who may benefit from PrEP and to feel comfortable prescribing PrEP
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