Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 11, 2020
Open Peer Review Period: Sep 10, 2020 - Nov 5, 2020
Date Accepted: Jan 21, 2021
(closed for review but you can still tweet)
The Context and Barriers of the Prescription of Nonoccupational Postexposure Prophylaxis among HIV Medical Care Providers: National Internet-based Observational Study in China
ABSTRACT
Background:
Nonoccupational postexposure prophylaxis (nPEP) is an effective HIV biomedical prevention strategy. While previously nPEP guidelines for HIV were mainly released in developed countries, little is known on the perception, attitude, and practice of nPEP in HIV medical care providers in developing countries.
Objective:
We aimed to assess the nPEP perception and prescribing practice among HIV medical care providers in China.
Methods:
HIV medical care providers were recruited in China during May to June 2019, through an online survey regarding nPEP-related knowledge, attitudes, and clinical prescription experiences. Multivariable logistic regression was performed to identify factors associated with prescribing nPEP among HIV medical care providers.
Results:
Totally, 777 eligible participants participated in this study, who are from 133 cities in 31 provinces in China. Of the participants, only 39.8% (309/777) understood nPEP well. Overall, 53.3% (414/777) of participants once prescribed nPEP, among whom 38.9% (161/414) encountered barriers in the prescription process. HIV medical care providers who working in a specialized infectious disease hospital (vs. general hospital: adjusted odds ratio (aOR), 2.50; 95% confidence interval (CI), 1.86–3.35), and having previously prescribed occupational PEP (oPEP, aOR, 4.55; 95% CI, 3.08–6.73), had a significantly positive association with prescribing nPEP; however, self-reported having no oPEP guideline in place (aOR, 0.53; 95% CI, 0.36–0.79), as well as believing nPEP may promote HIV high-risk behavior (aOR, 0.52; 95% CI, 0.36–0.76) or result in HIV drug resistance (aOR, 0.53; 95% CI, 0.36–0.77) among key populations, were negatively associated with nPEP prescription behavior.
Conclusions:
HIV medical care providers have a poor nPEP perception and an inadequate proportion of prescribing, which may impede the smooth implementation of nPEP to prevent HIV infection. The development of a national nPEP guideline would improve the situation.
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