Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England
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{"title"=>"Knowledge, beliefs and practices regarding antiretroviral medications for HIV prevention: Results from a survey of healthcare providers in New England", "type"=>"journal", "authors"=>[{"first_name"=>"Douglas S.", "last_name"=>"Krakower", "scopus_author_id"=>"6506764099"}, {"first_name"=>"Catherine E.", "last_name"=>"Oldenburg", "scopus_author_id"=>"56033174900"}, {"first_name"=>"Jennifer A.", "last_name"=>"Mitty", "scopus_author_id"=>"6602733945"}, {"first_name"=>"Ira B.", "last_name"=>"Wilson", "scopus_author_id"=>"56497466500"}, {"first_name"=>"Ann E.", "last_name"=>"Kurth", "scopus_author_id"=>"7005633635"}, {"first_name"=>"Kevin M.", "last_name"=>"Maloney", "scopus_author_id"=>"56222343400"}, {"first_name"=>"Donna", "last_name"=>"Gallagher", "scopus_author_id"=>"8129501100"}, {"first_name"=>"Kenneth H.", "last_name"=>"Mayer", "scopus_author_id"=>"7201681809"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84940094707", "pmid"=>"26146824", "doi"=>"10.1371/journal.pone.0132398", "pui"=>"605749749", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "sgr"=>"84940094707"}, "id"=>"db7a84a0-69c0-3dec-8106-6dc79d803fda", "abstract"=>"BACKGROUND: Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and pre-exposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited.\\n\\nMETHODS: Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices.\\n\\nRESULTS: Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01-1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98-11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06-1.34), whereas female gender (aOR 0.26, 95% CI 0.10-0.71) was associated with having not prescribed PrEP.\\n\\nCONCLUSIONS: These findings suggest many clinicians have shifted towards routinely recommending early ART, but not PrEP, so interventions to facilitate PrEP provision are needed.", "link"=>"http://www.mendeley.com/research/knowledge-beliefs-practices-regarding-antiretroviral-medications-hiv-prevention-results-survey-healt", "reader_count"=>56, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Student > Doctoral Student"=>3, "Researcher"=>10, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>3, "Student > Master"=>10, "Other"=>8, "Student > Bachelor"=>9, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Student > Doctoral Student"=>3, "Researcher"=>10, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>3, "Student > Master"=>10, "Other"=>8, "Student > Bachelor"=>9, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Biochemistry, Genetics and Molecular Biology"=>2, "Nursing and Health Professions"=>3, "Medicine and Dentistry"=>29, "Agricultural and Biological Sciences"=>2, "Philosophy"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Business, Management and Accounting"=>1, "Psychology"=>4, "Social Sciences"=>6, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>29}, "Social Sciences"=>{"Social Sciences"=>6}, "Psychology"=>{"Psychology"=>4}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Unspecified"=>{"Unspecified"=>5}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"United States"=>3, "Brazil"=>1}, "group_count"=>4}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2162659"], "description"=>"<p>Numbers within bars represent the percentage of participants selecting each response category. Data are restricted to clinicians from specialties for which PrEP prescribing may be feasible, i.e., those that involve provision of longitudinal medical care.</p>", "links"=>[], "tags"=>["New England BackgroundAntiretroviral treatment", "aor", "aids", "U.S", "ci", "PrEP provision", "HIV Treatment Guidelines", "clinician"], "article_id"=>1473792, "categories"=>["Biological Sciences"], "users"=>["Douglas S. Krakower", "Catherine E. Oldenburg", "Jennifer A. Mitty", "Ira B. Wilson", "Ann E. Kurth", "Kevin M. Maloney", "Donna Gallagher", "Kenneth H. Mayer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0132398.g003", "stats"=>{"downloads"=>5, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinicians_8217_perceived_barriers_to_prescribing_pre_exposure_prophylaxis_n_155_New_England_2013_/1473792", "title"=>"Clinicians’ perceived barriers to prescribing pre-exposure prophylaxis (n = 155), New England, 2013.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-06 02:48:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/2162660", "https://ndownloader.figshare.com/files/2162661"], "description"=>"<div><p>Background</p><p>Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and pre-exposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited.</p><p>Methods</p><p>Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices.</p><p>Results</p><p>Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01–1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98–11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06–1.34), whereas female gender (aOR 0.26, 95% CI 0.10–0.71) was associated with having not prescribed PrEP.</p><p>Conclusions</p><p>These findings suggest many clinicians have shifted towards routinely recommending early ART, but not PrEP, so interventions to facilitate PrEP provision are needed.</p></div>", "links"=>[], "tags"=>["New England BackgroundAntiretroviral treatment", "aor", "aids", "U.S", "ci", "PrEP provision", "HIV Treatment Guidelines", "clinician"], "article_id"=>1473793, "categories"=>["Biological Sciences"], "users"=>["Douglas S. Krakower", "Catherine E. Oldenburg", "Jennifer A. Mitty", "Ira B. Wilson", "Ann E. Kurth", "Kevin M. Maloney", "Donna Gallagher", "Kenneth H. Mayer"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0132398.s001", "https://dx.doi.org/10.1371/journal.pone.0132398.s002"], "stats"=>{"downloads"=>3, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Knowledge_Beliefs_and_Practices_Regarding_Antiretroviral_Medications_for_HIV_Prevention_Results_from_a_Survey_of_Healthcare_Providers_in_New_England_/1473793", "title"=>"Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-07-06 02:48:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/2162657"], "description"=>"<p>Participants were presented with statements about early antiretroviral treatment and asked to indicate their degree of agreement (strongly agree, agree, disagree, strongly disagree). Numbers within bars represent the percentage of respondents selecting each response category. Blue shading represents agreement, whereas red shading represents disagreement. Data are restricted to clinicians who have prescribed antiretroviral therapy to at least 1 HIV-infected patient in the prior year.</p>", "links"=>[], "tags"=>["New England BackgroundAntiretroviral treatment", "aor", "aids", "U.S", "ci", "PrEP provision", "HIV Treatment Guidelines", "clinician"], "article_id"=>1473790, "categories"=>["Biological Sciences"], "users"=>["Douglas S. Krakower", "Catherine E. Oldenburg", "Jennifer A. Mitty", "Ira B. Wilson", "Ann E. Kurth", "Kevin M. Maloney", "Donna Gallagher", "Kenneth H. Mayer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0132398.g001", "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinician_beliefs_and_reported_practices_regarding_early_antiretroviral_treatment_n_105_New_England_2013_/1473790", "title"=>"Clinician beliefs and reported practices regarding early antiretroviral treatment (n = 105), New England, 2013.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-06 02:48:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/2162658"], "description"=>"<p>Participants indicated their degree of agreement (strongly agree, agree, neutral, disagree, strongly disagree) to statements about pre-exposure prophylaxis. Numbers within bars represent the percentage of respondents selecting each response category. Blue shading represents agreement, neutral shading represents neutrality, and red shading represents disagreement.</p>", "links"=>[], "tags"=>["New England BackgroundAntiretroviral treatment", "aor", "aids", "U.S", "ci", "PrEP provision", "HIV Treatment Guidelines", "clinician"], "article_id"=>1473791, "categories"=>["Biological Sciences"], "users"=>["Douglas S. Krakower", "Catherine E. Oldenburg", "Jennifer A. Mitty", "Ira B. Wilson", "Ann E. Kurth", "Kevin M. Maloney", "Donna Gallagher", "Kenneth H. Mayer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0132398.g002", "stats"=>{"downloads"=>2, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinician_beliefs_regarding_pre_exposure_prophylaxis_n_181_New_England_2013_/1473791", "title"=>"Clinician beliefs regarding pre-exposure prophylaxis (n = 181), New England, 2013.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-06 02:48:25"}

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{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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