Journal of primary care & community health · 2025
A Theory Informed Multi-Component Intervention to Promote Family Medicine Provider PrEP Prescription to Adolescent Girls and Young Women in the U.S. Southeast: Pilot Trial Results.
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Matthews Lynn T, Pratt Madeline C, Isehunwa Oluwaseyi O, Klasen Lillian M, Hill Samantha V, Simpson Tina, Hubner Brook A, Van Wagoner Nicholas, Lanzi Robin Gaines, Gupta Vikas, Nadkar Trupti, Malhotra Shivani, Krakower Douglas S, Wood Tara E, Long Dustin M, Elopre Latesha E
Аннотация
BACKGROUND: Adolescent girls and young women (AGYW) in the U.S. Southeast are disproportionately affected by HIV. We developed and piloted PrEP-Pro, an intervention to support family medicine residents to prescribe HIV pre-exposure prophylaxis (PrEP), with a focus on AGYW. We pilot-tested the intervention, evaluating feasibility, acceptability, and appropriateness.
METHODS: Using intervention mapping, we developed sexual history training, PrEP curricula, and a PrEP champion program. For the 6-month pilot test, we trained PrEP champions who trained and supported residents at their sites. Participating physicians completed enrollment and exit questionnaires capturing PrEP provision experiences, attitudes/skills/barriers to completing a sexual history, and PrEP knowledge/attitudes/beliefs. Exit questionnaires assessed PrEP-Pro acceptability, feasibility, and appropriateness. We compared enrollment and exit scores on sexual history assessment, PrEP knowledge, and provider behaviors.
RESULTS: Among 46 participants (median age = 29 years), 57% were men, 59% were White, 15% were Asian, 11% were Latinx, and 7% were Black. Among 32 (70%) participants completing both enrollment and exit questionnaires, we observed significant increases in sexual history skills, PrEP knowledge, and PrEP attitudes, and non-significant increases in the proportion reporting routine sexual history assessment and HIV testing. On a 5-point scale, feasibility (mean 4.28 (SD = 0.42), acceptability (4.31 (0.53)), and appropriateness (4.25 (0.46)) scores were high with respect to the PrEP-Pro intervention.
CONCLUSION: This multi-component intervention was feasible, acceptable, and appropriate for family medicine residents in the pilot. Pre- and post-evaluation suggest participation in the intervention increased PrEP knowledge and improved sexual history-taking. These findings suggest that the intervention could successfully enhance provider self-efficacy in delivering sexual health care.
METHODS: Using intervention mapping, we developed sexual history training, PrEP curricula, and a PrEP champion program. For the 6-month pilot test, we trained PrEP champions who trained and supported residents at their sites. Participating physicians completed enrollment and exit questionnaires capturing PrEP provision experiences, attitudes/skills/barriers to completing a sexual history, and PrEP knowledge/attitudes/beliefs. Exit questionnaires assessed PrEP-Pro acceptability, feasibility, and appropriateness. We compared enrollment and exit scores on sexual history assessment, PrEP knowledge, and provider behaviors.
RESULTS: Among 46 participants (median age = 29 years), 57% were men, 59% were White, 15% were Asian, 11% were Latinx, and 7% were Black. Among 32 (70%) participants completing both enrollment and exit questionnaires, we observed significant increases in sexual history skills, PrEP knowledge, and PrEP attitudes, and non-significant increases in the proportion reporting routine sexual history assessment and HIV testing. On a 5-point scale, feasibility (mean 4.28 (SD = 0.42), acceptability (4.31 (0.53)), and appropriateness (4.25 (0.46)) scores were high with respect to the PrEP-Pro intervention.
CONCLUSION: This multi-component intervention was feasible, acceptable, and appropriate for family medicine residents in the pilot. Pre- and post-evaluation suggest participation in the intervention increased PrEP knowledge and improved sexual history-taking. These findings suggest that the intervention could successfully enhance provider self-efficacy in delivering sexual health care.