The University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA.
Womens Health (Lond). 2024 Jan-Dec;20:17455057241277974. doi: 10.1177/17455057241277974.
Awareness and uptake of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) remains low among Black/African American cisgender women, partly due to low self-reported PrEP knowledge and comfort among primary care providers. Ensuring providers are trained on PrEP is crucial, as increased PrEP knowledge is associated with higher rates of PrEP prescription.
We aimed to develop a PrEP training for providers to improve their self-efficacy in discussing and prescribing PrEP for Black women, with the ultimate goal of increasing PrEP awareness and utilization among Black women.
In this qualitative study, we conducted focus groups with medical providers at three federally qualified health centers in the Southern and Midwestern United States to identify themes informing the development of a provider PrEP training.
Providers were asked for input on content/design of PrEP training. Transcripts underwent rapid qualitative analysis using the Stanford Lightning Report Method. Themes were identified and presented under the domains of the Consolidated Framework for Implementation Research.
Ten providers completed four focus groups. Themes included the individual characteristics of providers (low comfort initiating PrEP discussions, particularly among White providers) and the outer setting of client attitudes (perceptions of potential provider bias/racism, varying levels of concern about HIV acquisition). Opportunities were identified to maximize the benefit of training design (e.g., developing case scenarios to enhance providers' cultural competency with Black women and PrEP knowledge).
This comprehensive PrEP training features both didactic material and interactive role-plays to equip providers with the clinical knowledge for prescribing PrEP while building their competency discussing PrEP with Black women. This training is particularly important for providers who have racial or gender discordance with Black women and express lower comfort discussing PrEP with these clients. Provider training could lead to minimizing racial- and gender-based inequities in PrEP use.
在黑人和非裔美国顺性别女性中，艾滋病毒（HIV）暴露前预防（PrEP）的知晓率和接受率仍然很低，部分原因是初级保健提供者自我报告的 PrEP 知识和舒适度较低。确保提供者接受 PrEP 培训至关重要，因为增加 PrEP 知识与更高的 PrEP 处方率相关。
我们旨在为提供者提供 PrEP 培训，以提高他们为黑人女性讨论和开处 PrEP 的自我效能，最终目标是提高黑人女性对 PrEP 的认识和利用。
在这项定性研究中，我们在美国南部和中西部的三家联邦合格的健康中心进行了焦点小组讨论，以确定为提供者提供 PrEP 培训的主题。
要求提供者就 PrEP 培训的内容/设计提供意见。使用斯坦福闪电报告方法对转录本进行快速定性分析。根据实施研究综合框架确定并呈现主题。
十名提供者完成了四组焦点小组讨论。主题包括提供者的个体特征（低舒适度，特别是白人提供者启动 PrEP 讨论）和客户态度的外部环境（对潜在提供者偏见/种族主义的看法，对 HIV 感染的不同程度关注）。确定了机会来最大限度地提高培训设计的好处（例如，制定案例场景以增强提供者与黑人女性和 PrEP 知识的文化能力）。
这种全面的 PrEP 培训既有理论材料又有互动角色扮演，为提供者提供了开具 PrEP 处方的临床知识，同时培养了他们与黑人女性讨论 PrEP 的能力。对于那些与黑人女性存在种族或性别差异并且对与这些患者讨论 PrEP 的舒适度较低的提供者来说，这种培训尤为重要。提供者培训可以最大限度地减少 PrEP 使用中的种族和性别不平等。
