Table IV.
Perceived Barriers to and Negative Attitudes toward Prescribing PrEP by Provider Type and Prescribing Experience and Willingness Among Non-Prescribers to Engage in PrEP Activities.
| HIVPs | PCPs | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| |||||||||||||
| Ever Prescribed | Ever Prescribed | ||||||||||||
|
| |||||||||||||
| Overall (N=490) |
HIVPs (N=229) |
PCPs (N=261) |
B (SE) | OR | Yes (N=147) |
No (N=82) |
Χ2 | OR | Yes (N=46) |
No (N=215) |
Χ2 | OR | |
| Any barriers to prescribing | 83% | 75% | 90% | 1.14 (0.28)*** | 3.11 | 70% | 83% | 4.60* | 2.08 | 78% | 92% | 7.82** | 3.24 |
| Specific barriers | |||||||||||||
| Completing prior authorizations | 60% | 54% | 64% | 0.34 (0.20) | 1.40 | 50% | 61% | 2.40 | 1.54 | 50% | 67% | 5.03* | 2.07 |
| Patients’ insurance coverage | 57% | 56% | 59% | 0.03 (0.20) | 1.03 | 54% | 57% | 0.18 | 1.13 | 44% | 62% | 5.57* | 2.15 |
| Knowledge about PrEP | 44% | 19% | 66% | 1.96 (0.23)*** | 7.12 | 12% | 32% | 14.00*** | 3.55 | 33% | 73% | 26.77*** | 5.46 |
| Time needed to counsel on risk-reduction | 39% | 25% | 51% | 1.10 (0.21)*** | 3.02 | 19% | 37% | 8.56** | 2.45 | 35% | 55% | 6.13* | 2.28 |
| Other staff’s capacity | 32% | 20% | 43% | 1.13 (0.23)*** | 3.10 | 13% | 33% | 13.12*** | 3.31 | 24% | 47% | 7.92** | 2.77 |
| Clinical capacity | 32% | 23% | 40% | 0.73 (0.22)*** | 2.07 | 15% | 38% | 15.44*** | 3.45 | 22% | 43% | 7.34** | 2.74 |
| Follow-up visits for monitoring | 30% | 20% | 38% | 0.95 (0.23)*** | 2.58 | 14% | 31% | 8.61** | 2.63 | 24% | 41% | 4.90* | 2.25 |
| Provider reimbursement for visits | 25% | 22% | 27% | 0.02 (0.23) | 1.02 | 21% | 24% | 0.33 | 1.21 | 15% | 30% | 4.05* | 2.36 |
| Clinical policies/corporate restrictions | 18% | 16% | 21% | 0.28 (0.26) | 1.33 | 10% | 27% | 11.90*** | 3.48 | 7% | 24% | 6.83** | 4.46 |
| Willingness to prescribe | 16% | 10% | 21% | 0.62 (0.29)* | 1.86 | 6% | 17% | 6.99** | 3.16 | 7% | 24% | 6.83** | 4.46 |
| Comfort discussing sexual matters | 10% | 7% | 12% | 0.27 (0.35) | 1.31 | 6% | 9% | 0.47 | 1.43 | 2% | 14% | 5.28* | 7.58 |
| Thoughts about whether PrEP is ethical | 8% | 8% | 8% | −0.05 (0.36) | 0.95 | 8% | 10% | 0.36 | 1.34 | 4% | 9% | 1.21 | 2.26 |
|
| |||||||||||||
| Any negative attitudes | 54% | 45% | 61% | 0.54 (0.20)** | 1.71 | 40% | 55% | 5.06* | 1.87 | 46% | 64% | 5.47* | 2.13 |
| Negative attitudes | |||||||||||||
| People should use condoms instead of PrEP | 34% | 30% | 38% | 0.25 (0.28) | 1.28 | 25% | 39% | 4.80* | 1.90 | 30% | 40% | 1.33 | 1.50 |
| PrEP results in risk compensation | 22% | 20% | 23% | 0.28 (0.21) | 1.33 | 17% | 24% | 1.82 | 1.57 | 17% | 25% | 1.12 | 1.55 |
| PrEP will increase resistance | 22% | 19% | 25% | 0.17 (0.24) | 1.18 | 15% | 26% | 3.91* | 1.96 | 22% | 26% | 0.30 | 1.24 |
| PrEP users are not likely to adhere | 18% | 17% | 19% | 0.28 (0.25) | 1.32 | 13% | 24% | 4.90* | 2.17 | 7% | 22% | 5.76* | 4.01 |
| PrEP is too costly | 16% | 14% | 18% | 0.14 (0.27) | 1.15 | 13% | 16% | 0.38 | 1.27 | 11% | 19% | 1.76 | 1.93 |
***
p < .001
**
p < .01
*
p < .05
Provider types were compared using logistic regression, controlling for geographic region and professional position. Prescribers and non-prescribers were compared using chi-square tests.