Department of Psychiatry & Behavioral Neuroscience, The University of Chicago Medicine, 5841 S. Maryland Avenue, MC 3077, Chicago, IL 60637, United States.
Department of Psychology, College of Health Professions, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, United States.
Curr Pharm Teach Learn. 2023 Feb;15(2):139-148. doi: 10.1016/j.cptl.2023.02.019. Epub 2023 Mar 8.
Men who have sex with men (MSM), especially Black MSM, are disproportionately affected by HIV and experience disparate prescription of pre-exposure prophylaxis (PrEP) for HIV prevention compared to White MSM. While pharmacists are essential in efforts to scale-up PrEP, little is known about the role of knowledge and implicit biases in pharmacy students' decision-making regarding PrEP, which may elucidate mechanisms for improving PrEP access and addressing disparities.
A nationwide, cross-sectional study of pharmacy students in the United States was conducted. A fictional White or Black MSM seeking PrEP was presented. Participants completed measures of PrEP/HIV knowledge, implicit racism and heterosexism, assumptions about the patient's behavior (condomless sex, extra-relational sex, adherence to PrEP), and confidence providing PrEP-related care.
A total of 194 pharmacy students completed the study. Compared to the White patient, the Black patient was assumed to be less adherent to PrEP if prescribed. In contrast, assumptions of sexual risk behaviors if prescribed PrEP and confidence providing PrEP-related care did not differ. Additionally, implicit racism was associated with lower confidence providing PrEP-related care, whereas PrEP/HIV knowledge, implicit sexual orientation bias, and assumed sexual risk behaviors if prescribed PrEP were not associated with confidence.
Pharmacists are essential in efforts to scale-up PrEP prescription, making pharmacy education about PrEP for HIV prevention critical. These findings suggest that implicit bias awareness training is needed. This training may reduce the influence of implicit racial bias on confidence providing PrEP-related care and improve knowledge of HIV and PrEP.
男男性行为者（MSM），尤其是黑人 MSM，受到 HIV 的影响不成比例，与白人 MSM 相比，他们接受 HIV 预防用暴露前预防（PrEP）的处方存在明显差异。虽然药剂师在扩大 PrEP 规模的努力中至关重要，但对于药房学生在决定 PrEP 方面的知识和隐性偏见的作用知之甚少，这可能阐明了改善 PrEP 可及性和解决差异的机制。
在美国进行了一项针对药学专业学生的全国性横断面研究。介绍了一位虚构的寻求 PrEP 的白人或黑人 MSM 患者。参与者完成了 PrEP/HIV 知识、隐性种族主义和异性恋偏见、对患者行为（无保护性行为、非伴侣性行为、遵守 PrEP）的假设以及提供 PrEP 相关护理的信心的评估。
共有 194 名药学专业学生完成了研究。与白人患者相比，如果开了 PrEP，黑人患者被认为不太遵守 PrEP。相比之下，如果开了 PrEP，对性行为风险行为的假设和提供 PrEP 相关护理的信心没有差异。此外，隐性种族主义与提供 PrEP 相关护理的信心较低相关，而 PrEP/HIV 知识、隐性性取向偏见和如果开了 PrEP 对性行为风险行为的假设与信心无关。
药剂师在扩大 PrEP 处方的努力中至关重要，因此，对预防 HIV 的 PrEP 进行药学教育至关重要。这些发现表明需要进行隐性偏见意识培训。这种培训可能会减少隐性种族偏见对提供 PrEP 相关护理的信心的影响，并提高对 HIV 和 PrEP 的知识。
