Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA.
Department of Behavioral Sciences and Leadership, United States Air Force Academy, Colorado Springs, CO, USA.
Sci Rep. 2023 Oct 8;13(1):16958. doi: 10.1038/s41598-023-44165-9.
Although HIV pre-exposure prophylaxis (PrEP) effectively and safely prevents HIV among adolescents, uptake of PrEP is low. Adolescents must have primary care providers (PCPs) prescribe them PrEP, making PCPs critical actors in PrEP delivery. However, research has primarily investigated determinants of PCPs' intention to prescribe adolescents PrEP rather than the determinants of performing the behavior itself. We examined the demographic, clinical practice, and implementation determinants of PCPs previously prescribing PrEP to adolescents. PCPs were recruited from a national Qualtrics panel of licensed medical providers in the United States from July 15-August 19, 2022. The Theoretical Domains Framework informed the implementation determinants measured. A multivariable logistic regression was used. PCPs who were more knowledgeable of the CDC guidelines (aOR 2.97, 95% CI 2.16-4.10), who were assigned male at birth (aOR 1.64, 95% CI 1.03-2.59), and who practiced in the Western region (aOR 1.85, 95% CI 1.04-3.30) had greater odds of prior prescribing adolescents PrEP. Provider-based educational interventions should be designed, implemented, and tested to encourage PCPs to prescribe PrEP to eligible adolescents.
尽管 HIV 暴露前预防(PrEP)能有效且安全地预防青少年感染 HIV,但 PrEP 的使用率很低。青少年必须让初级保健提供者(PCP)为他们开具 PrEP,这使得 PCP 成为 PrEP 提供的关键角色。然而,研究主要调查了 PCP 开具青少年 PrEP 意愿的决定因素,而不是执行该行为本身的决定因素。我们研究了之前为青少年开具 PrEP 的 PCP 的人口统计学、临床实践和实施决定因素。PCP 是从 2022 年 7 月 15 日至 8 月 19 日从美国全国性的 Qualtrics 许可医疗服务提供者小组中招募的。实施决定因素是根据理论领域框架进行测量的。采用多变量逻辑回归。更了解 CDC 指南的 PCP(OR 2.97,95%CI 2.16-4.10)、出生时为男性的 PCP(OR 1.64,95%CI 1.03-2.59)和在西部地区执业的 PCP(OR 1.85,95%CI 1.04-3.30)更有可能之前为青少年开具 PrEP。应设计、实施和测试以提供者为基础的教育干预措施,以鼓励 PCP 为符合条件的青少年开具 PrEP。
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