Why some primary care providers are more likely to prescribe HIV prevention medicine to adolescents

Adolescents and young adults are one of the demographic groups most affected by HIV. In 2019, 21 percent of new HIV infections were among people between the ages of 13 and 24. However, despite these disproportionate figures, use of pre-exposure prophylaxis (PrEP) to prevent HIV infection in this age cohort is extremely low.

A new study published in the Journal of Adolescent Health explores primary care physicians’ attitudes and intentions related to prescribing PrEP to adolescents. In the study, a research team led by Christopher Owens, PhD,  assistant professor in the Department of Health Behavior at the Texas A&M University School of Public Health, uses data from a survey of physicians in the United States to analyze how provider knowledge, social influences and environmental resources might affect attitudes and intentions toward PrEP. This study joins previous research by Owens focusing on PrEP-related knowledge, attitudes and actions among adolescents and their parents.

The researchers found that physicians who knew more about prescribing guidelines, had positive perceived norms and professional roles, and greater clinic environmental resources (such as having handouts for patients, support staff to educate and help patients and electronic medical record systems) had higher intent to prescribe PrEP to adolescents.

“We need to make sure that primary care providers are prepared to prescribe PrEP to eligible adolescents,” Owens said. “This preparedness is multifaceted: it can be on the individual-level like continuing medical education opportunities, on the interpersonal-level like having multidisciplinary and support teams, and on the organizational-level like electronic or paper forms.”

Study findings show primary care physician knowledge, attitudes and resources could affect PrEP uptake rates. The findings could be used to build interventions that improve provider knowledge and help give physicians the resources they need to educate adolescents patients and their parents, as well overcome physician barriers to prescribing PrEP, such as concerns about remembering the PrEP prescribing guidelines and concerns about medication monitoring.

Having better resources inside the clinic setting for primary care physicians and their patients could improve uptake of PrEP among eligible adolescents, which could help reduce the burden of HIV infections on this vulnerable group.