PrEP Promotion Through Clinician Collaboration

Segment Description: Ian Frank, MD, professor of medicine, Perelman School of Medicine, University of Pennsylvania, addresses reasons why some clinicians are not recommending PrEP to individuals who could benefit from the regimen.

Interview transcript: (modified slightly for readability)

Contagion®: How would you address a clinician who is not recommending PrEP to patients that are at a higher risk for HIV? What are some barriers to the implementation of HIV prevention and how can we overcome them?

Ian Frank, MD: “Providers who are not recommending PrEP either are not aware of it, are not aware of its efficacy — how safe it is for individuals and how easy it is to prescribe – or they’re not doing careful sexual histories on their patient’s and they don’t know that individuals are in a risk group or engaging in behaviors that could put them at risk for acquiring HIV-infection. Or maybe they’re a little bit lazy.

It’s fine if a provider doesn’t feel comfortable in prescribing PrEP, they should just refer that individual to another provider who has comfort and knowledge. In a group practice setting, it’s helpful for one individual to be the champion of PrEP and be the one that feels educated and comfortable prescribing PrEP and be the partner in the practice that gets referred the individuals who need PrEP. And that is sometimes the best way to handle that for providers who are just a little less comfortable with PrEP. Certainly, PrEP is like any other type of practice in medicine, we don’t always feel comfortable and we don’t often have the time to maintain our knowledge base in one particular area of medicine or another.

So, we need to work as a team to make sure that individuals who need PrEP, or could benefit from PrEP have access to it, and that starts with a provider who is aware of it and feels comfortable prescribing it or referring for people who need it.”