Literature DB >> 33735209

Decentralizing PrEP delivery: Implementation and dissemination strategies to increase PrEP uptake among MSM in Toronto, Canada.

Maxime Charest1,2, Malika Sharma3,4,5, Allison Chris6, Alexandre Schnubb2, David C Knox5, James Wilton7, Rita Shahin6, Arlene Chan8, Sharmistha Mishra2,3,9,10,11, Daniel Grace12, Ahmed M Bayoumi3,9,11,13, John Maxwell14, Isaac I Bogoch3,15, Darrell H S Tan2,3,9,15.   

Abstract

Pre-exposure prophylaxis (PrEP) is traditionally prescribed by HIV specialist physicians. Given finite specialist resources, there is a need to scale up PrEP delivery by decentralizing services via other healthcare professionals. We aimed to assess the feasibility of delivering PrEP to men who have sex with men (MSM) through primary care physicians and sexual health clinic nurses. We piloted a multi-component, implementation and dissemination research program to increase provision of PrEP through primary care physicians and sexual health clinic nurses in Toronto, Canada. Community-based organizations (CBOs) provided prospective participants with information cards that contained links to an online module on engaging providers in a conversation about PrEP. In our patient-initiated continuing medical education (PICME) strategy, participants saw their family doctors and gave them the card, which also contained a link to a Continuing Medical Education module. In the nurse-led strategy, participants visited one of two participating clinics to obtain PrEP. We administered an optional online questionnaire to patients and providers at baseline and six months. CBOs distributed 3043 cards. At least 339 men accessed the online module and 196 completed baseline questionnaires. Most (55%) intended to visit nurses while 21% intended to consult their physicians. Among 45 men completing follow-up questionnaires at 6 months, 31% reported bringing cards to their physicians and obtaining PrEP through them; sexual health clinics delivered PrEP to 244 patients. Participants who went through the PICME approach reported no changes in relationships with their providers. Nurses showed fidelity to PrEP prescribing guidelines. Nurse-led PrEP and patient-initiated continuing medical education (PICME) for primary care physicians are feasible strategies to increase PrEP uptake. Nurse-led PrEP delivery was preferred by most patients.

Entities:  

Year:  2021        PMID： 33735209      PMCID： PMC7971529          DOI： 10.1371/journal.pone.0248626

Source DB:  PubMed          Journal:  PLoS One        ISSN： 1932-6203            Impact factor:   3.240


  25 in total

1.  United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.

Authors:  Dominika Seidman; Kimberly Carlson; Shannon Weber; Jacki Witt; Patricia J Kelly
Journal:  Contraception       Date:  2016-01-06       Impact factor: 3.375

2.  Positioning dissemination in public health policy.

Authors:  D R MacLean
Journal:  Can J Public Health       Date:  1996 Nov-Dec

3.  Nurse-led pre-exposure prophylaxis: a non-traditional model to provide HIV prevention in a resource-constrained, pragmatic clinical trial.

Authors:  Heather-Marie A Schmidt; Ruthy McIver; Rebecca Houghton; Christine Selvey; Anna McNulty; Rick Varma; Andrew E Grulich; Joanne Holden
Journal:  Sex Health       Date:  2018-11       Impact factor: 2.706

Review 4.  Do You PrEP? A Review of Primary Care Provider Knowledge of PrEP and Attitudes on Prescribing PrEP.

Authors:  Leah Turner; Abbey Roepke; Emily Wardell; Anne M Teitelman
Journal:  J Assoc Nurses AIDS Care       Date:  2017-11-22       Impact factor: 1.354

5.  Nurse-Led HIV PEP Program Used by Men at High Risk for HIV Seroconversion.

Authors:  Patrick O'Byrne; Paul MacPherson; Lauren Orser
Journal:  J Assoc Nurses AIDS Care       Date:  2018-02-17       Impact factor: 1.354

6.  Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection.

Authors:  John Schneider; Sherrie H Kaplan; Sheldon Greenfield; Wenjun Li; Ira B Wilson
Journal:  J Gen Intern Med       Date:  2004-11       Impact factor: 5.128

7.  Exploring nurse-led HIV Pre-Exposure Prophylaxis in a community health care clinic.

Authors:  Marion Selfridge; Kiffer G Card; Karen Lundgren; Tamara Barnett; Kellie Guarasci; Anne Drost; Christiane Gray-Schleihauf; Roz Milne; Jonathan Degenhardt; Aeron Stark; Mark Hull; Chris Fraser; Nathan J Lachowsky
Journal:  Public Health Nurs       Date:  2020-09-29       Impact factor: 1.462

8.  US Guideline Criteria for Human Immunodeficiency Virus Preexposure Prophylaxis: Clinical Considerations and Caveats.

Authors:  Sarah K Calabrese; Douglas S Krakower; Tiara C Willie; Trace S Kershaw; Kenneth H Mayer
Journal:  Clin Infect Dis       Date:  2019-08-16       Impact factor: 9.079

9.  HIV in Canada-Surveillance Report, 2018.

Authors:  N Haddad; A Robert; A Weeks; N Popovic; W Siu; C Archibald
Journal:  Can Commun Dis Rep       Date:  2019-12-05

10.  Trends in the awareness, acceptability, and usage of HIV pre-exposure prophylaxis among at-risk men who have sex with men in Toronto.

Authors:  Jayoti Rana; James Wilton; Shawn Fowler; Trevor A Hart; Ahmed M Bayoumi; Darrell H S Tan
Journal:  Can J Public Health       Date:  2018-04-26
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  5 in total

1.  Women's Perceptions of HIV- and Sexuality-Related Stigma in Relation to PrEP: Qualitative Findings from the Masibambane Study, Durban, South Africa.

Authors:  J Hanass-Hancock; S Hoffman; S Bergam; A D Harrison; N Benghu; S Khumalo; N Tesfay; T Exner; L Miller; C Dolezal
Journal:  AIDS Behav       Date:  2022-02-26

2.  Association between the geographic accessibility of PrEP and PrEP use among MSM in nonurban areas.

Authors:  J Danielle Sharpe; Travis H Sanchez; Aaron J Siegler; Jodie L Guest; Patrick S Sullivan
Journal:  J Rural Health       Date:  2022-01-07       Impact factor: 5.667

3.  "It's a win for the clinic, it's a win for the frontline, but, most importantly, it's a win for the client": Task Shifting HIV Prevention Services from Clinicians to Community Health Workers in Ontario, Canada.

Authors:  David J Brennan; Maxime Charest; Aaron Turpin; Dane Griffiths; Barry D Adam; John Maxwell; Keith McCrady; Robbie Ahmed
Journal:  Sex Res Social Policy       Date:  2022-04-28

4.  "What other choices might I have made?": Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk.

Authors:  Mark Gaspar; Alex Wells; Mark Hull; Darrell H S Tan; Nathan Lachowsky; Daniel Grace
Journal:  Qual Health Res       Date:  2022-05-26

Review 5.  Pre-exposure prophylaxis for HIV: effective and underused.

Authors:  Amanda Hempel; Mia J Biondi; Jean-Guy Baril; Darrell H S Tan
Journal:  CMAJ       Date:  2022-09-06       Impact factor: 16.859
  5 in total

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