Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk Community
Objective: To assess pre-exposure prophylaxis (PrEP) knowledge and prescribing confidence one year after implementation of an obstetrics and gynecology (OBGYN) resident curriculum and evaluate barriers to PrEP prescribing in an OBGYN resident clinic. Materials and Methods: This mixed methods study e...
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Mary Ann Liebert
2024-04-01
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| Series: | Women's Health Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/whr.2024.0123 |
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| author | Anna Marie P. Young Saba Berhie Havisha Pedamallu Lane Patterson Lynn M. Yee |
| author_facet | Anna Marie P. Young Saba Berhie Havisha Pedamallu Lane Patterson Lynn M. Yee |
| author_sort | Anna Marie P. Young |
| collection | DOAJ |
| description | Objective: To assess pre-exposure prophylaxis (PrEP) knowledge and prescribing confidence one year after implementation of an obstetrics and gynecology (OBGYN) resident curriculum and evaluate barriers to PrEP prescribing in an OBGYN resident clinic. Materials and Methods: This mixed methods study evaluated OBGYN residents who provide care in a high HIV prevalence city. Resident physicians, including those who did and did not participate in the original curriculum, completed a survey of knowledge and comfort prescribing PrEP; responses were compared with previously collected survey results from prior to and immediately after the curriculum. Second, we conducted focus groups and individual interviews (n = 12 participants) to assess perceived barriers and areas for improvement in PrEP delivery. Transcripts were coded via Dedoose software and organized according to themes using a constant comparative approach. Results: The average score for the knowledge evaluation was 62.6%, which was lower than the immediate postcurriculum scores from one year prior (78.9%, p < 0.05). A significantly lower proportion of residents reported that they were comfortable with prescribing PrEP compared with the prior year (26.1% vs. 71.9%, p < 0.05). Only 56% of residents reported counseling a patient in clinic about PrEP, and 34% had reported prescribing PrEP 1-year postcurriculum. Qualitative themes regarding barriers to PrEP provision included knowledge, institutional, operational, and perceived low-risk population. Potential solutions for each barrier included department-wide and recurring education for all training levels, introduction of a PrEP monitoring pathway, implementation of nursing questionnaires, task lists, pretemplated texts, and increasing awareness of PrEP. Conclusion: Beyond educational deficits, several other operational and institutional barriers prevent the full inclusion of PrEP provision in an academic OBGYN ambulatory setting. |
| format | Article |
| id | doaj-art-3233d8b566aa4e40bcb9f2d786d1bf7d |
| institution | DOAJ |
| issn | 2688-4844 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Women's Health Reports |
| spelling | doaj-art-3233d8b566aa4e40bcb9f2d786d1bf7d2025-08-20T03:09:55ZengMary Ann LiebertWomen's Health Reports2688-48442024-04-015182583010.1089/whr.2024.0123Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk CommunityAnna Marie P. Young0Saba Berhie1Havisha Pedamallu2Lane Patterson3Lynn M. Yee4Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.Department of Obstetrics and Gynecology, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts, USA.Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.Objective: To assess pre-exposure prophylaxis (PrEP) knowledge and prescribing confidence one year after implementation of an obstetrics and gynecology (OBGYN) resident curriculum and evaluate barriers to PrEP prescribing in an OBGYN resident clinic. Materials and Methods: This mixed methods study evaluated OBGYN residents who provide care in a high HIV prevalence city. Resident physicians, including those who did and did not participate in the original curriculum, completed a survey of knowledge and comfort prescribing PrEP; responses were compared with previously collected survey results from prior to and immediately after the curriculum. Second, we conducted focus groups and individual interviews (n = 12 participants) to assess perceived barriers and areas for improvement in PrEP delivery. Transcripts were coded via Dedoose software and organized according to themes using a constant comparative approach. Results: The average score for the knowledge evaluation was 62.6%, which was lower than the immediate postcurriculum scores from one year prior (78.9%, p < 0.05). A significantly lower proportion of residents reported that they were comfortable with prescribing PrEP compared with the prior year (26.1% vs. 71.9%, p < 0.05). Only 56% of residents reported counseling a patient in clinic about PrEP, and 34% had reported prescribing PrEP 1-year postcurriculum. Qualitative themes regarding barriers to PrEP provision included knowledge, institutional, operational, and perceived low-risk population. Potential solutions for each barrier included department-wide and recurring education for all training levels, introduction of a PrEP monitoring pathway, implementation of nursing questionnaires, task lists, pretemplated texts, and increasing awareness of PrEP. Conclusion: Beyond educational deficits, several other operational and institutional barriers prevent the full inclusion of PrEP provision in an academic OBGYN ambulatory setting.https://www.liebertpub.com/doi/10.1089/whr.2024.0123HIV/AIDSobstetricsgynecologyacademic medicine |
| spellingShingle | Anna Marie P. Young Saba Berhie Havisha Pedamallu Lane Patterson Lynn M. Yee Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk Community Women's Health Reports HIV/AIDS obstetrics gynecology academic medicine |
| title | Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk Community |
| title_full | Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk Community |
| title_fullStr | Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk Community |
| title_full_unstemmed | Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk Community |
| title_short | Assessing Barriers in Obstetrics and Gynecology Trainee Knowledge and Prescribing of HIV Pre-Exposure Prophylaxis in a High-Risk Community |
| title_sort | assessing barriers in obstetrics and gynecology trainee knowledge and prescribing of hiv pre exposure prophylaxis in a high risk community |
| topic | HIV/AIDS obstetrics gynecology academic medicine |
| url | https://www.liebertpub.com/doi/10.1089/whr.2024.0123 |
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