Clinician Attitudes Toward CDC Interim Pre-Exposure Prophylaxis (PrEP) Guidance and Operationalizing PrEP for Adolescents

• DOI: 10.1089/apc.2014.0273
• Publication Date: 2015-02-18T17:37:39Z
• Authors: Tanya L. Kowalczy...; Michelle Lally; Gregory Zimet; Jessica A. Kahn
• Keywords: Pre-exposure prophylaxis; Interim; Serodiscordant; Demographics

Prior to issuing formal HIV pre-exposure prophylaxis (PrEP) clinical practice guidelines in 2014, the US Centers for Disease Control and Prevention (CDC) had released interim guidance oral PrEP use among adults. Because may be used off-label youth soon indicated minor adolescents, we examined potential adoption of clinicians who care HIV-infected at-risk youth. Individual, semi-structured interviews were conducted with 15 recruited through an adolescent research network. The theory-driven interview guide, consisting primarily open-ended questions, assessed demographics, familiarity guidance, attitudes toward adult patients. Transcripts analyzed using framework analysis. Most (11/15) reported that was compatible their practice, although several some aspects, particularly frequency follow-up visits, needed tailored meet patients' needs. We found variability clinician characteristics appropriate candidates (e.g., substance mental health issues noted both suitable unsuitable candidates) serodiscordant couples whether would recommended a patient whose partner is virally suppressed). Clinician steps initiation, monitoring, discontinuing largely consistent guidance. observed regard reduced interventions educate about content rationale guideline recommendations.