Department of Pediatrics, UCSF-Benioff Children's Hospital, University of California, San Francisco, California.
Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
J Adolesc Health. 2018 Aug;63(2):242-244. doi: 10.1016/j.jadohealth.2018.03.016. Epub 2018 May 26.
HIV disproportionately affects young men who have sex with men. Pre-exposure prophylaxis (PrEP) can prevent HIV acquisition; however, youth access to PrEP is limited by provider willingness to prescribe PrEP.
We conducted an online survey of clinicians working with adolescents (aged 13-17 years) and young adults (aged 18-26 years) in the United States through the Society of Adolescent Health and Medicine. We used multivariate logistic regression to assess provider beliefs associated with willingness to provide PrEP.
Nearly all (93.2%) providers had heard of PrEP, and 57 (35.2%) had prescribed PrEP. While almost all providers (95%) agreed that PrEP prevents HIV, fewer were willing to prescribe to young adults (77.8%) or adolescents (64.8%). Willingness to prescribe PrEP was strongly associated with the belief that providers had enough knowledge to safely provide PrEP to adolescents (OR 2.11, confidence interval [CI]: 1.18-3.76, p = .01) and young adults (odds ratio 5.19, CI: 2.15-12.50, p ≤ .001), and that adolescents would be adherent (odds ratio 3, CI: 1.30-6.90, p = .01). Response rate was 17%.
Almost all providers had heard of PrEP and most providers were willing to prescribe PrEP. Provider education and tools to promote provider self-efficacy and adolescent adherence might improve provider willingness to provide PrEP.
艾滋病毒在男男性行为者中不成比例地影响年轻人。暴露前预防（PrEP）可以预防艾滋病毒的感染；然而，青年获得 PrEP 的机会受到提供者提供 PrEP 意愿的限制。
我们通过美国青少年健康医学学会对在美国为青少年（13-17 岁）和年轻成年人（18-26 岁）提供服务的临床医生进行了一项在线调查。我们使用多变量逻辑回归来评估与提供 PrEP 的意愿相关的提供者信念。
几乎所有（93.2%）的提供者都听说过 PrEP，57 名（35.2%）提供者曾开具 PrEP。虽然几乎所有的提供者（95%）都认为 PrEP 可以预防艾滋病毒，但愿意为年轻人（77.8%）或青少年（64.8%）开具 PrEP 的人则较少。愿意开具 PrEP 的意愿与提供者认为自己有足够的知识为青少年（OR 2.11，置信区间 [CI]：1.18-3.76，p =.01）和年轻成年人（OR 5.19，CI：2.15-12.50，p ≤.001）安全提供 PrEP 的信念以及青少年的依从性（OR 3，CI：1.30-6.90，p =.01）密切相关。回复率为 17%。
几乎所有的提供者都听说过 PrEP，大多数提供者都愿意开具 PrEP。提供者教育和工具可以提高提供者的自我效能感和青少年的依从性，从而改善提供者提供 PrEP 的意愿。
