A Guide for Designing Student-Led, Interprofessional Community Education Initiatives About HIV Risk and Pre-Exposure Prophylaxis

LGBTQ+ health education for medical students in the United States: a narrative literature review

INTRODUCTION

People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development.

METHODS

PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011-6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes.

RESULTS

One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions.

CONCLUSION

Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.

Psychiatry and Family Medicine Residents' Likelihood of Prescribing HIV Pre-exposure Prophylaxis to Patients With Mental Illness and HIV Vulnerability

BACKGROUND

People living with mental illness (PLMI) experience disproportionately high incidence of and vulnerability to HIV. Pre-exposure prophylaxis (PrEP) is an effective and safe HIV prevention method, but data regarding prescription to PLMI are lacking. Psychiatrists may serve as important points of access for PrEP prescription for PLMI.

METHODS

We conducted a vignette-based study of residents in psychiatry and family medicine (FM) to assess likelihood of prescribing PrEP and assumptions about the fictional patient. Participants were randomized to one of five vignettes in which the patients' psychiatric diagnosis was varied (schizophrenia on long-acting injectable or oral antipsychotic, bipolar disorder, major depression) or a control vignette without a psychiatric diagnosis.

RESULTS

A total of 439 residents participated. We found that high percentages of psychiatry (96.8%) and FM (97.4%) residents were aware of PrEP. High percentages of psychiatry (92.0%-98.1%) and FM (80.8%-100%) residents reported that PrEP was indicated for all patient conditions. Family medicine residents were more likely to prescribe PrEP to all experimental conditions than psychiatry residents. There was no difference in likelihood of prescribing to the control condition without a psychiatric diagnosis. The belief that PrEP prescription was out of scope of practice was greater among psychiatry residents.

CONCLUSIONS

A majority of psychiatry residents responded that PrEP was indicated for an array of patients with psychiatric diagnoses. However, psychiatry residents were broadly less likely to prescribe PrEP to patients with these diagnoses. The high percentage of psychiatry residents who reported that PrEP was indicated for all patients suggests that additional training is needed to facilitate PrEP prescription by psychiatrists.

Improving Delivery and Use of HIV Pre-Exposure Prophylaxis in the US: A Systematic Review of Implementation Strategies and Adjunctive Interventions

Implementation of pre-exposure prophylaxis (PrEP) to prevent HIV transmission is suboptimal in the United States. To date, the literature has focused on identifying determinants of PrEP use, with a lesser focus on developing and testing change methods to improve PrEP implementation. Moreover, the change methods available for improving the uptake and sustained use of PrEP have not been systematically categorized. To summarize the state of the literature, we conducted a systematic review of the implementation strategies used to improve PrEP implementation among delivery systems and providers, as well as the adjunctive interventions used to improve the uptake and persistent adherence to PrEP among patients. Between November 2020 and January 2021, we searched Ovid MEDLINE, PsycINFO, and Web of Science for peer reviewed articles. We identified 44 change methods (18 implementation strategies and 26 adjunctive interventions) across a variety of clinical and community-based service settings. We coded implementation strategies and adjunctive interventions in accordance with established taxonomies and reporting guidelines. Most studies focused on improving patient adherence to PrEP and most conducted pilot trials. Just over one-third of included studies demonstrated a positive effect on outcomes. In order to end the human immunodeficiency virus (HIV) epidemic in the U.S., future, large scale HIV prevention research is needed that develops and evaluates implementation strategies and adjunctive interventions for target populations disproportionately affected by HIV.

Pre-exposure prophylaxis (PrEP) among people who use drugs: a qualitative scoping review of implementation determinants and change methods

Implementation of pre-exposure prophylaxis (PrEP) to prevent HIV transmission is suboptimal in the United States, particularly among people who use drugs (PWUD). PrEP research among PWUD is scarce, and the factors that impact implementation are largely unknown. Therefore, we conducted a scoping review of implementation determinants (i.e., barriers and facilitators), as well as the change methods (implementation strategies and adjunctive interventions) that have been evaluated to increase PrEP implementation and use among PWUD. We identified 32 peer-reviewed articles assessing determinants and five that evaluated change methods. Determinants were coded using the updated Consolidated Framework for Implementation Research (CFIR), which is an established framework to understand the multilevel barriers and facilitators associated with implementation. Findings indicate that most research was conducted among PrEP recipients (i.e., patients), focusing on awareness and willingness to use PrEP, with less focus on factors impacting clinicians and service delivery systems. Moreover, very few change methods have been evaluated to improve clinician adoption and adherence to CDC guidelines for PrEP provision and/or recipient uptake and adherence to PrEP. Future research is needed that focuses on factors impacting implementation from a clinician standpoint as well as innovative change methods to increase PrEP awareness, reach, adoption, and sustained adherence to guidelines. Implementation Science offers a wealth of knowledge to speed up the effort to end the HIV epidemic in the United States.

Extracurricular activities in medical education: an integrative literature review

BACKGROUND

The importance of extracurricular activities (EAs) has been emphasized in medical education. These activities could enhance medical students' emotional and physical health and afford them developmental opportunities. Despite the growing amount of research related to this theme, few studies review and synthesize the existing literature. This study aims to provide an understanding of the educational implications of EAs in medical colleges and constructs an integrated conceptual framework concerning their types and learning outcomes by literature review.

METHODS

An integrative literature review was conducted following Torraco's method, with the aim to generate a new framework for the given topic. The authors utilized Scopus and PubMed as databases, using search terms "extracurricular," "medical," and "students." Initially, titles and abstracts were screened to include relevant studies, and the researchers verified the eligibility of the articles by following the inclusion and exclusion criteria. Of the 263 articles identified, 64 empirical studies were selected for further review.

RESULTS

EAs in undergraduate medical education can be classified into direct extracurricular activities and indirect extracurricular activities, the latter of which is sorted into nine sub-categories. We identified seven main categories regarding the learning outcomes of EAs. In addition to general activities (e.g., pro-social activities, team sports), some distinctive activities such as research have been largely addressed in previous studies. The results of EAs were discussed in relation to academic growth, career development, and psychological experiences.

CONCLUSIONS

This review identified the types and learning outcomes of EAs in the context of medical education, thereby suggesting ways to improve the quality of EAs and maximize their educational effects.

Barriers and Facilitators to HIV Pre-Exposure Prophylaxis Uptake, Adherence, and Persistence Among Transgender Populations in the United States: A Systematic Review

HIV pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV; however, PrEP use among transgender individuals remains low. We conducted a systematic review to identify barriers and facilitators to PrEP uptake, adherence, and persistence among transgender individuals in the United States. We conducted a literature search in PubMed and CINAHL databases in March 2021 and followed PRISMA guidelines. Studies were eligible if they were published in a peer-reviewed journal and reported interest, uptake, adherence, and/or persistence of PrEP use among transgender individuals. Articles that did not disaggregate results for transgender participants were excluded. Data from included articles were coded using content analysis and narratively synthesized using a framework matrix. We screened 254 unique articles published after US Food and Drug Administration approval of PrEP, and 33 articles were included in the review. Five themes were identified in the literature, including (1) PrEP concentrations were lower among individuals taking feminizing hormones, but the difference did not appear clinically significant; (2) concerns regarding interactions between gender-affirming hormone therapy and PrEP remain a large barrier; (3) PrEP initiation may facilitate increased self-advocacy and self-acceptance; (4) lack of trust in medical institutions impacts PrEP uptake; and (5) social networks have a significant influence on PrEP knowledge, interest, and adherence. Additional research is needed involving transgender men and nonbinary persons, and efforts to improve PrEP persistence among the transgender community are needed. Training health care providers to provide inclusive and affirming care is perhaps one of the strongest areas for intervention to increase PrEP uptake and persistence.

Student-led curricular approaches in medical education: the educational effects of a virtual fundamentals of COVID-19 course

BACKGROUND

As the field of education was adapting to virtual learning during the COVID-19 pandemic, a need quickly emerged for a course to prepare medical students for future clinical practice. This call to action was answered by creating an innovative Fundamentals of COVID-19 course at the Indiana University School of Medicine (IUSM). As a group of medical student leaders at IUSM, we developed this online course in order to support our fellow students and the community.

METHODS

The study examined the educational effects of completing the Fundamentals of COVID-19 course. In order to examine these effects, the study asked enrolled students to complete both a pre- and post-course self-assessment survey. Students were asked an identical set of questions on each survey about their knowledge, skills, and abilities (KSA) regarding COVID-19. Composite scores were created for each KSA learning domain. Responses were provided using a five-point Likert scale ranging from 1 = strongly disagree to 5 = strongly agree.

RESULTS

Out of the 724 students enrolled, 645 students completed both the pre- and post-course assessment surveys. Findings show that there were both meaningful and statistically significant differences in students' responses to the pre- and post-course surveys. Results show 1.) a significant mean increase in the knowledge composite score of 1.01, 95% CI [0.95, 1.06], t(644) = 36.4, p < .001, d = 1.43; 2.) a significant mean increase in the skills composite score of .55, 95% CI [0.50, 0.60], t(644) = 20.70, p < .001, d = 0.81. and 3.) a significant mean increase of the abilities composite score of 1.02, 95% CI [.97, 1.07], t(644) = 36.56, p < .001, d = 1.44.

CONCLUSIONS

These findings demonstrate that the student-developed, online Fundamentals of COVID-19 course resulted in notable and statistically significant educational effects. The increase in students' self-reported ratings, especially in the knowledge and abilities domains, indicate that meaningful learning occurred within the course. These findings have notable implications for medical student training during healthcare emergencies, such as a pandemic, as well as within modern clerkship environments. Overall, our findings provide evidence that student-led curricular design and virtual delivery of course content can be effective tools in undergraduate medical education.

Fostering cultural sensitivity amongst students of pharmacy through an interprofessional book club activity

BACKGROUND AND PURPOSE

To describe a large-scale, cultural sensitivity-focused interprofessional book club activity that is required in the first-professional year of an accelerated pharmacy curriculum.

EDUCATIONAL ACTIVITY AND SETTING

An interprofessional book club activity, focusing on the need for cultural sensitivity in health care, is conducted annually for students in the acupuncture, pharmacy, physical therapy, physician assistant, and sonography programs. Each year over 400 students are required to attend and are assigned to interprofessional groups to discuss guided questions pertaining to the book written by Anne Fadiman, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Pharmacy students complete multiple assignments before and after the activity. Students are administered a post-survey to collect student feedback and self-assessment data. The book club has been run in both synchronous and asynchronous formats.

FINDINGS

Student survey responses have consistently revealed that the majority of students agreed or strongly agreed that they were better prepared for culturally-diverse patient interactions, the activity allowed for interprofessional learning, and the activity should continue for future students.

SUMMARY

A book club activity is an effective strategy for delivering content related to cultural sensitivity in an interprofessional format. This activity model can be used to support interactions with multiple professions in different schools within the same university or with multiple professions located at different universities/institutions.

A national strategy to engage medical students in otolaryngology-head and neck surgery medical education: the LearnENT ambassador program

BACKGROUND

In the realm of medical education, student-led ambassador programs represent an innovative approach to increase awareness about medical education resources. LearnENT is an internationally recognized otolaryngology-head and neck surgery (OHNS) smartphone app and website designed for medical trainees to learn about OHNS. However, upon the initial launch of the app, there was a lack of medical student awareness and engagement.

APPROACH

In this article, we highlight the process and lessons learned from developing an ambassador program to increase the national presence and uptake of LearnENT. Medical students from across Canada were recruited and trained to promote the app at their respective institutions.

EVALUATION

Ambassadors hosted events and spearheaded initiatives around the country with the goal of showcasing LearnENT. Furthermore, ambassadors were engaged in scholarly initiatives such as creating educational content for LearnENT and giving presentations at national conferences.

REFLECTIONS

Critical factors in the success of a student-led ambassador program include ensuring widespread dissemination of the program, establishing clear expectations for ambassadors, equipping ambassadors with standardized promotional material, and promoting collaboration to collectively work towards addressing challenges. When creating a national student-led group such as an ambassador program, outreach to senior stakeholders can be an effective way to involve students at different institutions, provide mentorship opportunities for students and provide opportunities for educational scholarship. With new medical education innovations constantly surfacing, the LearnENT ambassador program model can be applied in other contexts to increase awareness of medical education resources.

Qualitative investigation of factors impacting pre-exposure prophylaxis initiation and adherence in sexual minority men

Introduction

Men who have sex with men continue to account for the majority of new HIV infections in the United States. Many of those with new infections are unaware that they have HIV. Preventative measures continue to be essential in reducing new infections, with pre‐exposure prophylaxis (PrEP) being widely recommended.

Objectives

The overall aim of this qualitative study is to explore the impact of stigma, patient–provider dynamics and patient perception of PrEP on men's engagement with PrEP in a primary care setting.

Methods

The Consensual Qualitative Research Methodology (Hill, 2012) was used to explore the experiences of 14 men receiving care for PrEP at a Family Medicine clinic in the Midwest. Semistructured interviews were conducted to allow for depth of understanding of individuals' experience.

Results

Four major domains were identified: motivation to pursue PrEP, barriers and adherence to care, beliefs about how PrEP is perceived by others and experiences discussing sexual health and PrEP with providers.

Conclusion

It is important to better understand factors contributing to the pursuit of and adherence to HIV prevention measures and HIV care. Further, health systems and providers are encouraged to consider opportunities in terms of how their practice can destigmatize PrEP use and offer a welcoming environment for those pursuing HIV prevention.

Patient or Public Contribution

Patients were involved in the study through their participation in semistructured interviews, which provided the data analysed for this study. There was no additional participation beyond the one‐time interview or follow‐up poststudy. Their interviews helped contribute to our better understanding of the needs and experiences of those receiving PrEP‐related care.

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

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.

Knowledge of HIV and HIV pre-exposure prophylaxis among medical and pharmacy students: A national, multi-site, cross-sectional study

Pre-exposure prophylaxis (PrEP) is a highly effective strategy for preventing HIV. However, prescription of PrEP has not reached the scale that is necessary to meet the public health need of reducing HIV incidence. A factor contributing to this slow scale-up is limited healthcare practitioners' knowledge of PrEP, making PrEP education a priority. We conducted a national, cross-sectional study of medical (allopathic and osteopathic) and pharmacy students regarding knowledge of PrEP and HIV between October 2020 and February 2021. We included 28 items in our knowledge assessment. Analysis sought to identify gaps in knowledge as well as academic and demographic correlates of knowledge. A total of 2,353 students participated in the study (response rate = 17.0%). The overall mean HIV knowledge score was 79.6% correct. Regarding specific items, 68.7% of participants believed HIV treatment was difficult because it required many pills, and 61.1% incorrectly indicated a person with an undetectable HIV viral load could transmit the virus to their sexual partners. Overall mean PrEP knowledge was 84.1%. Approximately one-third of participants did not identify HIV-negative status as a requirement to be a PrEP candidate. Gay/lesbian participants and those who were in the late-phase of training reported higher knowledge of both HIV and PrEP than did heterosexual participants and those in the early-phase of training. This study identifies specific gaps in training on HIV prevention with PrEP that must be improved in health professions education to ensure PrEP reaches its full potential in ending the HIV epidemic.

Impact of pharmacist-led program on knowledge of college students about pre-exposure prophylaxis

OBJECTIVE

This study's primary objective was to evaluate the impact of a pharmacist-led educational program on undergraduate college students' knowledge about PrEP.

METHODS

This was a cross-sectional, pre- and postprogram survey study. The study included undergraduate students at least 18 years old at a university in Washington, DC. Graduate students, pharmacy students, and those not enrolled at the university were excluded. Before the educational program, the participants completed an anonymous preprogram survey to assess their perception and knowledge of HIV prevention and PrEP as well as their willingness to obtain a prescription for PrEP. A pharmacist delivered a 30-minute educational program to students regarding HIV prevention and PrEP in small groups. After the program, the participants completed a postprogram survey to evaluate the changes from the baseline responses. Paired t tests and chi-square tests detected the associations between the pre- and postprogram surveys.

RESULTS

One-hundred sixteen students participated in the program, and 102 surveys were included in the data analysis. Students' perception of their knowledge of HIV (4.2 vs. 4.6; P < 0.001), perception of their knowledge of PrEP (3.1 vs. 4.5; P < 0.001), and their willingness to obtain a prescription for PrEP (3.8 vs. 4.5; P < 0.001) was statistically significant after the education. There was a statistically significant increase in the participants' actual knowledge of HIV risk factors (62.4% correct vs. 90.2% correct; P < 0.001) and knowledge of PrEP effectiveness (26.3% vs. 75.0%; P < 0.001).

CONCLUSION

These findings demonstrated that a pharmacist-led educational program may have an impact on undergraduate students' perception and knowledge of HIV and PrEP. This study may help to further guide pharmacists' PrEP initiatives in this targeted population.

Infectious Complications in Injection Drug Use

INTRODUCTION

The prevalence of opioid use disorder has increased steadily over the last decade (from 2.2 million in 2010 to 10.2 million in 2018) and with it, a surge in infectious complications associated with injection drug use (IDU). Trainees in internal medicine routinely diagnose, manage, and treat patients experiencing these infections in the hospital setting as well as screen for and immunize against other comorbid infections in the ambulatory setting.

METHODS

This 90-minute, case-based, interactive workshop was led by two facilitators, an infectious diseases specialist and a senior internal medicine resident. To evaluate its effectiveness, we used a pre- and postsession survey administered at the beginning and end of the workshop. Learners were asked to rate comfort level in recognizing, managing, and counseling about various IDU-related infections, as well as to answer specific, content-level questions.

RESULT

Thirty of 42 participants who attended the workshop completed the evaluation. There was a statistically significant change in participants' comfort level with diagnosing and managing IDU-associated infections as well as ambulatory standards of care for people who inject drugs (PWID) from pre- to postworkshop.

DISCUSSION

Our workshop focused on the management and prevention of infections among PWID in both the inpatient and ambulatory settings. Learners demonstrated increased comfort in managing these conditions.

Pre-Exposure Prophylaxis Training among Medical Schools in the United States

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

Impact of pharmacist-led program on knowledge of college students about pre-exposure prophylaxis

OBJECTIVE

This study's primary objective was to evaluate the impact of a pharmacist-led educational program on undergraduate college students' knowledge about PrEP.

METHODS

This was a cross-sectional, pre- and postprogram survey study. The study included undergraduate students at least 18 years old at a university in Washington, DC. Graduate students, pharmacy students, and those not enrolled at the university were excluded. Before the educational program, the participants completed an anonymous preprogram survey to assess their perception and knowledge of HIV prevention and PrEP as well as their willingness to obtain a prescription for PrEP. A pharmacist delivered a 30-minute educational program to students regarding HIV prevention and PrEP in small groups. After the program, the participants completed a postprogram survey to evaluate the changes from the baseline responses. Paired t tests and chi-square tests detected the associations between the pre- and postprogram surveys.

RESULTS

One-hundred sixteen students participated in the program, and 102 surveys were included in the data analysis. Students' perception of their knowledge of HIV (4.2 vs. 4.6; P < 0.001), perception of their knowledge of PrEP (3.1 vs. 4.5; P < 0.001), and their willingness to obtain a prescription for PrEP (3.8 vs. 4.5; P < 0.001) was statistically significant after the education. There was a statistically significant increase in the participants' actual knowledge of HIV risk factors (62.4% correct vs. 90.2% correct; P < 0.001) and knowledge of PrEP effectiveness (26.3% vs. 75.0%; P < 0.001).

CONCLUSION

These findings demonstrated that a pharmacist-led educational program may have an impact on undergraduate students' perception and knowledge of HIV and PrEP. This study may help to further guide pharmacists' PrEP initiatives in this targeted population.

Student Education About Pre-exposure Prophylaxis (PrEP) Varies Between Regions of the United States

BACKGROUND

Daily, oral pre-exposure prophylaxis (PrEP) is an effective and safe prevention strategy for people at risk for HIV. However, prescription of PrEP has been limited for patients at the highest risk. Disparities in PrEP prescription are pronounced among racial and gender minority patients. A significant body of literature indicates that practicing healthcare providers have little awareness and knowledge of PrEP. Very little work has investigated the education about PrEP among health professionals in training.

OBJECTIVE

The objective of this study was to compare health professions students' awareness of PrEP and education about PrEP between regions of the US, and to determine if correlations between regional HIV incidence and PrEP use were present.

DESIGN

Survey study.

PARTICIPANTS

A cross-sectional sample of health professions students (N = 1859) representing future prescribers (MD, DO, PA), pharmacists, and nurses in the US.

KEY RESULTS

Overall, 83.4% of students were aware of PrEP, but only 62.2% of fourth-year students indicated they had been taught about PrEP at any time during their training. Education about PrEP was most comprehensive in the Northeastern US, the area with the highest PrEP to need ratio (4.7). In all regions, transgender patients and heterosexual men and women were least likely to be presented in education as PrEP candidates, and men who have sex with men were the most frequently presented.

CONCLUSIONS

There are marked differences in education regarding PrEP both between academic programs and regions of the USA.

PrEP (Pre-Exposure Prophylaxis) Education for Clinicians: Caring for an MSM Patient

INTRODUCTION

Gaps exist in educational materials addressing LGBTQ patient care and LGBTQ health. One such area is prescribing HIV pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM). PrEP awareness, familiarity, and comfort in prescribing are very important in the rollout and success of PrEP as a preventative measure. Our needs assessments showed a lack of familiarity and comfort among clinicians/medical students in prescribing PrEP. Furthermore, studies have shown that since its launch as an effective prevention method of HIV transmission, PrEP has not been widely prescribed to at-risk populations. Educating clinicians about PrEP may increase its use among high-risk MSM populations and reduce the incidence of HIV infections.

METHODS

For medical students, we developed a didactic presentation and video recording discussing (1) a brief history of HIV prevention, (2) indications for PrEP prescription, (3) medical testing for PrEP onboarding, (4) common PrEP side effects, and (5) appropriate follow-up and testing for PrEP maintenance and discontinuation. We also developed a videotaped clinical encounter demonstrating communication skills used in PrEP counseling. Pre- and postworkshop surveys assessed participants' PrEP attitudes and knowledge.

RESULTS

All 43 survey respondents were second- through fourth-year medical students. Pre- and postpresentation evaluation of questions assessing comfort demonstrated a statistically significant improvement in level of comfort with understanding when to prescribe PrEP and in level of knowledge in prescribing PrEP.

DISCUSSION

Workshop participants acknowledged their training gaps in PrEP prescribing and acquired knowledge and comfort with prescribing PrEP for at-risk populations.