PrEP University: A Multi-Disciplinary University-Based HIV Prevention Education Program

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Abstract

The introduction of emtricitabine/tenofovir diphosphate (FTC/TDF) as pre-exposure prophylaxis (PrEP) for HIV prevention has raised questions regarding which clinicians will serve as prescribers and how providers will be educated about this HIV prevention strategy. We piloted an HIV Prevention Education Program called PrEP University (PrEP U) to address knowledge gaps in HIV prevention among medical trainees. We examined PrEP awareness and assessed learning as a result of the program, measuring knowledge before and after the lectures with an anonymous 5-question multiple choice test. A total of 198 learners participated in PrEP University, which included 127 first year medical students, and post-graduate trainees in internal medicine (n = 23), family medicine (n = 16), OBGYN (n = 13) and pharmacy (n = 19). Prior to PrEP U, 27% of all participants were not aware of PrEP and an additional 8% were unsure if they had heard of it. Knowledge increased significantly after the education program among trainees in OBGYN (2.3 vs 3.8, p < 0.001), pharmacy (1.4 vs 2.5, p = 0.012) and school of medicine (3.3 vs 4.4, p < 0.001), with a trend seen in family medicine (2.7 vs. 3.7, p = 0.067) and internal medicine (2.7 vs 3.4, p = 0.068). Overall, an HIV Prevention Education Program was successfully administered to nearly 200 participants and resulted in improved knowledge of HIV prevention and PrEP across. Pharmacists and OBGYN physicians are two groups with an expanding role in the use of PrEP. Similar programs at other medical schools should be implemented to ensure that future physicians and pharmacists are comfortable with PrEP prescription.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10900-021-01007-x.

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Most cited references 31

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Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men

Robert M Grant, Javier R Lama, Peter L Anderson … (2010)

Antiretroviral chemoprophylaxis before exposure is a promising approach for the prevention of human immunodeficiency virus (HIV) acquisition. We randomly assigned 2499 HIV-seronegative men or transgender women who have sex with men to receive a combination of two oral antiretroviral drugs, emtricitabine and tenofovir disoproxil fumarate (FTC-TDF), or placebo once daily. All subjects received HIV testing, risk-reduction counseling, condoms, and management of sexually transmitted infections. The study subjects were followed for 3324 person-years (median, 1.2 years; maximum, 2.8 years). Of these subjects, 10 were found to have been infected with HIV at enrollment, and 100 became infected during follow-up (36 in the FTC-TDF group and 64 in the placebo group), indicating a 44% reduction in the incidence of HIV (95% confidence interval, 15 to 63; P=0.005). In the FTC-TDF group, the study drug was detected in 22 of 43 of seronegative subjects (51%) and in 3 of 34 HIV-infected subjects (9%) (P<0.001). Nausea was reported more frequently during the first 4 weeks in the FTC-TDF group than in the placebo group (P<0.001). The two groups had similar rates of serious adverse events (P=0.57). Oral FTC-TDF provided protection against the acquisition of HIV infection among the subjects. Detectable blood levels strongly correlated with the prophylactic effect. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; ClinicalTrials.gov number, NCT00458393.).

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Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women

Jared Baeten, Deborah Donnell, Patrick Ndase … (2012)

New England Journal of Medicine, 367(5), 399-410

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Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana.

Michael Thigpen, Poloko M. Kebaabetswe, Lynn Paxton … (2012)

Preexposure prophylaxis with antiretroviral agents has been shown to reduce the transmission of human immunodeficiency virus (HIV) among men who have sex with men; however, the efficacy among heterosexuals is uncertain. We randomly assigned HIV-seronegative men and women to receive either tenofovir disoproxil fumarate and emtricitabine (TDF-FTC) or matching placebo once daily. Monthly study visits were scheduled, and participants received a comprehensive package of prevention services, including HIV testing, counseling on adherence to medication, management of sexually transmitted infections, monitoring for adverse events, and individualized counseling on risk reduction; bone mineral density testing was performed semiannually in a subgroup of participants. A total of 1219 men and women underwent randomization (45.7% women) and were followed for 1563 person-years (median, 1.1 years; maximum, 3.7 years). Because of low retention and logistic limitations, we concluded the study early and followed enrolled participants through an orderly study closure rather than expanding enrollment. The TDF-FTC group had higher rates of nausea (18.5% vs. 7.1%, P<0.001), vomiting (11.3% vs. 7.1%, P=0.008), and dizziness (15.1% vs. 11.0%, P=0.03) than the placebo group, but the rates of serious adverse events were similar (P=0.90). Participants who received TDF-FTC, as compared with those who received placebo, had a significant decline in bone mineral density. K65R, M184V, and A62V resistance mutations developed in 1 participant in the TDF-FTC group who had had an unrecognized acute HIV infection at enrollment. In a modified intention-to-treat analysis that included the 33 participants who became infected during the study (9 in the TDF-FTC group and 24 in the placebo group; 1.2 and 3.1 infections per 100 person-years, respectively), the efficacy of TDF-FTC was 62.2% (95% confidence interval, 21.5 to 83.4; P=0.03). Daily TDF-FTC prophylaxis prevented HIV infection in sexually active heterosexual adults. The long-term safety of daily TDF-FTC prophylaxis, including the effect on bone mineral density, remains unknown. (Funded by the Centers for Disease Control and Prevention and the National Institutes of Health; TDF2 ClinicalTrials.gov number, NCT00448669.).

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Author and article information

Contributors

Sophie M. Cannon:

ORCID: http://orcid.org/0000-0003-1643-6944

sophiemcannon@gmail.com

Journal

Journal ID (nlm-ta): J Community Health

Journal ID (iso-abbrev): J Community Health

Title: Journal of Community Health

Publisher: Springer US (New York )

ISSN (Print): 0094-5145

ISSN (Electronic): 1573-3610

Publication date (Electronic): 9 June 2021

Publication date PMC-release: 9 June 2021

Publication date (Print): 2021

Volume: 46

Issue: 6

Pages: 1213-1220

Affiliations

[1 ]GRID grid.413086.8, ISNI 0000 0004 0435 1668, Department of Medicine, Antiviral Research Center, , UCSD Medical Center, ; 220 Dickinson Street, Suite A, San Diego, CA 92103 USA

[2 ]GRID grid.267313.2, ISNI 0000 0000 9482 7121, Department of Internal Medicine, , UT Southwestern, ; Dallas, TX 75390 USA

[3 ]GRID grid.266100.3, ISNI 0000 0001 2107 4242, Obstetrics, Gynecology and Reproductive Sciences, , University of California, San Diego, ; San Diego, CA 92103 USA

[4 ]GRID grid.266100.3, ISNI 0000 0001 2107 4242, Department of Psychiatry, , University of California, San Diego, ; San Diego, CA 92103 USA

Author information

Sophie M. Cannon http://orcid.org/0000-0003-1643-6944

Article

Publisher ID: 1007

DOI: 10.1007/s10900-021-01007-x

PMC ID: 8595182

PubMed ID: 34106369

SO-VID: 5162f75d-c529-4efa-bda5-aa936528b0cf

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Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 24 May 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;

Award ID: grant number KL2TR001444

Award Recipient : Jill Blumenthal

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ScienceOpen disciplines: Health & Social care

Keywords: prep,lgbtq health,preexposure prophylaxis,lgbtq medical education,hiv

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ScienceOpen disciplines: Health & Social care

Keywords: prep, lgbtq health, preexposure prophylaxis, lgbtq medical education, hiv

PrEP University: A Multi-Disciplinary University-Based HIV Prevention Education Program

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Tobacco Prevention & Cessation

Most cited references 31

Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men

Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women

Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana.

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