The HIV epidemic stubbornly persists despite a proven tool to prevent the spread

The HIV epidemic in the country remains stubbornly persistent, with nearly 40,000 new infections each year in the United States. This is despite the fact that doctors have a proven tool to prevent the spread of the virus in high-risk people. The question that arises is: why is pre-exposure prophylaxis, or PrEP, not more widely prescribed?

A new survey of more than 200 internal medicine residents suggests that the answer lies in the training physicians receive during the residency portion of their training.

The study published in the Journal of General Internal Medicine.

"I think we now know that if we train people, they will do it," said lead author Christopher Terndrup, MD, an assistant professor of medicine (general internal medicine and geriatrics) at the OHSU School of Medicine's Portland, Oregon. "We just have to make sure that happens."

Terndrup and his co-authors interviewed internal medicine residents at five university medical centers across the country. According to the survey, of the 229 residents who responded, more than half said they had heard of PrEP, but their knowledge of the drug and its side effects was low or fair.

"Residents who rated their knowledge more strongly reported a greater likelihood of prescribing PrEP in the future," the authors write.

Terndrup said the research builds on a previous survey published in 2016 of primary care physicians on familiarity with PrEP. The new study focuses on residents in internal medicine because of the importance of residency training in defining future medical practice.

At OHSU, Terndrup noted that residents in internal medicine undergo specific training to become more familiar with the offer of PrEP to patients at high risk of infection.

"If some programs do not train their residents, they should do it," Terndrup said.

The epidemic remains rooted in the homes of vulnerable individuals. For example, the Centers for Disease Control and Prevention recently reported an epidemic among a homeless population living in Seattle in 2018.

Meanwhile, a recent draft recommendation from the US Task Force on Preventive Services suggests that doctors offer PrEP with effective antiretroviral therapy to people at high risk of acquiring HIV. The study is the result of an evidence review led by Roger Chou, MD, director of the Northwestern Pacific Evidence-based Practice Center at OHSU and professor of medicine (General Internal Medicine and Geriatrics) at the University of Toronto. OHSU School of Medicine.

The new survey suggests that training should be improved throughout the country.

"Given the important need for PrEP, [internal medicine] residents must be trained to acquire the knowledge and comfort necessary to prescribe it, "write the authors.