Reyniers Thijs, Vuylsteke Bea, Pirotte Benoit, Hoornenborg Elske, Bil Janneke P, Wouters Kristien, Laga Marie, Nöstlinger Christiana
Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
Department of Infectious Diseases, Centre Hospitalier Régional (CHR) de Liège, Boulevard du Douzième de Ligne 1, 4000 Liège, Belgium.
Sex Health. 2018 Nov;15(6):606-611. doi: 10.1071/SH18072.
Background Physicians have a crucial role in the implementation and scale up of pre-exposure prophylaxis (PrEP). The objective of this study is to examine Belgian physicians' PrEP knowledge, concerns, acceptance and their willingness to prescribe PrEP.
A cross-sectional online survey was conducted between March and June 2016. Dissemination targeted Belgian primary care physicians (PCPs) and HIV specialists. Sociodemographic characteristics, experience with HIV and PrEP, self-assessed PrEP knowledge, concerns about PrEP, and PrEP acceptance were stratified according to professional background. Associations with willingness to prescribe PrEP were examined using univariable and multivariable binary logistic regression analyses.
In total, 333 completed surveys were included in the analysis. Sixty-two physicians (18.6%) scored their knowledge of PrEP to be good, 263 (79.0%) had an accepting attitude towards PrEP and 198 (59.5%) were willing to prescribe PrEP if approved in Belgium. HIV specialists consistently reported having better knowledge of PrEP, less concerns and a more accepting attitude towards PrEP than PCPs. In multivariable logistic regression analysis, higher PrEP knowledge (OR 2.4; 95%CI: 1.0-5.7) and higher PrEP acceptance (OR: 3.8; 95%CI: 2.1-6.8) remained significantly associated with the willingness to prescribe PrEP.
HIV specialists are better prepared to provide PrEP than PCPs in Belgium. Interventions to improve PrEP knowledge and acceptance among all providers are needed. The role of PCPs could be very important in optimising the rollout of PrEP, but additional training and guidelines will be needed.
背景 医生在暴露前预防（PrEP）的实施和推广中起着关键作用。本研究的目的是调查比利时医生对PrEP的知识、担忧、接受程度以及他们开具PrEP处方的意愿。
2016年3月至6月进行了一项横断面在线调查。调查对象为比利时初级保健医生（PCP）和HIV专家。根据专业背景，对社会人口学特征、HIV和PrEP经验、自我评估的PrEP知识、对PrEP的担忧以及PrEP接受程度进行分层。使用单变量和多变量二元逻辑回归分析来研究与开具PrEP处方意愿的关联。
总共333份完成的调查问卷纳入分析。62名医生（18.6%）将他们对PrEP的知识评为良好，263名（79.0%）对PrEP持接受态度，198名（59.5%）表示如果在比利时获得批准，愿意开具PrEP处方。HIV专家始终报告称，他们对PrEP的知识更丰富，担忧更少，对PrEP的接受态度比PCP更积极。在多变量逻辑回归分析中，较高的PrEP知识（比值比2.4；95%置信区间：1.0 - 5.7）和较高的PrEP接受程度（比值比：3.8；95%置信区间：2.1 - 6.8）仍然与开具PrEP处方的意愿显著相关。
在比利时，HIV专家比PCP更有准备提供PrEP。需要采取干预措施来提高所有医疗服务提供者对PrEP的知识和接受程度。PCP在优化PrEP推广方面的作用可能非常重要，但需要额外的培训和指导方针。
