How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium

Frontiers in Medicine

article

Jef Vanhamel¹  Thijs Reyniers¹  Edwin Wouters²  Josefien van Olmen³  Thibaut Vanbaelen⁴  Christiana Nöstlinger¹  Heleen Van Mieghem¹  Ella Van Landeghem¹  Anke Rotsaert¹  Marie Laga¹  Bea Vuylsteke¹ 

[1] Department of Public Health, Institute of Tropical Medicine;Department of Sociology, University of Antwerp;Department of Family Medicine and Population Health, University of Antwerp;Department of Clinical Sciences, Institute of Tropical Medicine

关键词: pre-exposure prophylaxis;    HIV prevention;    family physicians;    primary care;    service delivery;   

DOI  :  10.3389/fmed.2022.828695

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: In Belgium, the provision of pre-exposure prophylaxis (PrEP) for HIV prevention is centralized in specialized HIV clinics. Engaging family physicians in PrEP care could help scale-up its delivery and reach underserved populations. The objective of this study was to gain insight into family physicians' self-perceived roles in providing PrEP. Methods We conducted 16 online group discussions with a total of 105 Flemish family physicians, between November 2020 and February 2021. A brief online questionnaire assessed their socio-demographics and experience with sexual health. We analyzed verbatim transcribed data using a grounded theory approach. Results Despite limited awareness and experience, participants reported a high willingness to be more actively involved in PrEP care. Four potential roles for the family physician in PrEP care were identified: acting as low-threshold entry point for advice; opportunistic case finding of PrEP candidates; initiating appropriate care for PrEP-eligible clients; and ensuring high-quality follow-up care for PrEP users. Participants framed each of these roles within their current activities and responsibilities as primary care providers. Yet, participants differed in their views on the concrete operationalization of these roles, and in the extent of their involvement in PrEP. Particular challenges were a lack of experience with antiretrovirals, perceived limited exposure to clients at high HIV risk, and a lack of expertise and resources to conduct time-intensive risk assessments and counseling related to PrEP. Conclusion Belgian family physicians demonstrated a keen willingness to be involved in PrEP care, but had differing views on the practical implementation into their practices. Providing tailored training on sexual health and PrEP, and investing in collaboration between primary and secondary care, could optimize the integration of PrEP in the primary care practice.

【 授权许可】

CC BY