Amsterdam 2015
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| Abstract #2299 - PrEP | ||||
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Session: 50.2: PrEP (Symposium) on Friday @ 11.00-12.30 in C103 Chaired by John de Wit, Veronica Noseda Authors: Presenting Author: Mrs Elske Hoornenborg - GGD Amsterdam, Netherlands |
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| Additional Authors: | ||||
| Aim: Pre-exposure prophylaxis (PrEP) is a new biomedical approach that offers HIV-negative individuals a regime of lower-intensity antiretroviral therapy to reduce their risk of HIV-infection. Although PrEP is not yet registered the Netherlands, the positive outcomes of clinical trials on efficacy and safety may lead to its approval and implementation in the Netherlands. However, health care providers that are to provide PrEP in the future might have problematic beliefs and attitudes that can influence successful implementation of PrEP. Therefore, we aimed to gain insight into PrEP beliefs and attitudes towards PrEP prescription among health care providers working at an STI clinic. | ||||
| Method / Issue: In this qualitative study, we conducted two focus groups in October 2014 among medical doctors, nurses and doctor’s assistants (total n=16) working at the Amsterdam STI clinic, the largest clinic in the country with over 40,000 visits in 2014. | ||||
| Results / Comments: During focus groups, the following beliefs were identified for having a positive attitude towards PrEP prescription at STI clinics: (1) PrEP is an effective tool to prevent HIV (2) PrEP is a good addition to current prevention strategies (3) PrEP will most likely be cost-effective and (4) PrEP prescription is part of the core assignments of the STI-clinic. Beliefs for having a negative attitude towards PrEP prescription were: (1) PrEP is not an effective tool to prevent HIV (2) Priority should be to explore the reasons for non-condom use before introducing PrEP (3) PrEP will have a negative effect on behavioral interventions (4) There are alternative HIV prevention strategies that will be more effective (i.e. treatment as prevention, increasing HIV testing) (5) The high costs of PrEP will not outweigh the gains of PrEP (6) The STI clinic is not the right place to prescribe PrEP (e.g. limited knowledge of antiretroviral therapy use among the clinic’s care providers, limited capacity to guide individuals in taking daily PrEP) (7) The use of PrEP will lead to an increase in high risk behavior that might result in other sexually transmitted infections (8) There is not enough knowledge yet about PrEP and (9) it is unethical to prescribe healthy individuals antiretroviral therapy because it stimulates individuals to feel sick and it will help sustain a lifestyle of non-condom use. | ||||
| Discussion: In order to successfully implement PrEP in the future, beliefs about PrEP among health care professionals should be taken into consideration. Knowledge about PrEP efficacy, safety and risk compensation should be addressed among health care providers working at STI clinics to equip them with adequate knowledge and skills. | ||||
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