Examining primary care providers’ attitudes, behaviors, knowledge and confidence regarding Pre-Exposure Prophylaxis (PrEP) in Fulton County, Georgia Open Access

Niang, Seynabou Denise (Summer 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/8g84mn514?locale=en


Background: The Southern region of the United States constitutes the highest number of new HIV diagnosis in any region in the U.S. Fulton county, Georgia accounts for 1.5 percent of new diagnoses across the country. To better understand primary care providers (PCPs) engagement with patients at risk for HIV in Atlanta, this study examines PCPs’ confidence, attitudes, behaviors, and knowledge of PrEP, specifically in Fulton County, GA.

Methods: Six key informant interviews (KIIs) were conducted to examine attitudes, knowledge, and confidence around PrEP prescribing practices. Interviews were then transcribed and coded using MAXQDA2020. Data analysis was guided by grounded theory focusing on thematic and descriptive analyses.

Results: On average, participants demonstrated high confidence in prescribing PrEP. PCPs viewed PrEP as an effective medication in preventing HIV acquisition. All participants were confident in prescribing and discussing PrEP with patients but suspected many of their PCP colleagues may not be. Confidence in prescribing PrEP by PCPs perceived as closely attributed to a provider’s comfort in discussing sex and PrEP. Participants also perceived their colleagues had greater issues with prescribing PrEP.

Discussion: There is a need for additional training on PrEP care for PCPs, better communication, and empowerment tools for providers in discussing sexual practices, and enhanced electronic medical records system that can capture diverse sexual practices surrounding non-heterosexual and non-monogamous sexual practices. Future research is needed to examine support in sustaining the knowledge, confidence, and overall attitudes of prescribing PrEP among providers in HIV hotspot areas in the U.S.

Table of Contents

I. Introduction 1

A. Introduction and Rationale 1

B. Problem Statement 7

C. Purpose Statement 7

D. Research Questions 7

E. Significance Statement 8

F. Definition of Terms 8

II. Literature Review 9

III. Methodology 16

IV. Results 19

V. Discussion 28

VI. Recommendations 31

VII. References 33

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