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Training obstetrician gynaecologists in HIV PrEP (pre-exposure prophylaxis): a 2-year experience
  1. Francesca Silvestri1,
  2. Natalie Alvarez2,
  3. Omara Afzal2,
  4. Antonio E Urbina3,
  5. Siobhan M Dolan2,
  6. Andres Ramirez Zamudio4
  1. 1 Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  2. 2 Department of Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  3. 3 Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  4. 4 Department of Medicine, Division of Infectious Diseases & Department of Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  1. Correspondence to Dr Andres Ramirez Zamudio, Department of Medicine, Division of Infectious Diseases & Department of Obstetrics, Gynecology, and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; andres.ramirezzamudio{at}mssm.edu

Abstract

Objective We aimed to evaluate the efficacy of PrEP (pre-exposure prophylaxis) training sessions for OBGYN (obstetrician gynaecologist) providers given underutilisation of PrEP among women despite a high HIV burden.

Methods Three separate training sessions were held for providers in the OBGYN department at an academic medical centre in New York City from 2019 to 2021. The 1-hour training sessions were conducted by HIV specialists as in-person lectures or online live lectures. Participants were surveyed after the training on metrics of PrEP awareness, knowledge and comfort with management. Two-sample t-tests were used to compare difference in proportions of binomial variables and difference in means of Likert-scored answers pretraining and post-training events.

Results 63 respondents completed the surveys. There were low rates (13%) of past PrEP prescription among the respondents, while awareness of PrEP as an HIV prevention strategy was high before (95%) and after (98%) the training. After the training, there was an increase in understanding the epidemiology of HIV transmission (40% to 97%, p<0.00), familiarity with the PrEP clinical trials (18% to 97%, p<0.00), comfort in determining PrEP candidacy (mean score 2.3 to 4.1, p<0.00) and comfort prescribing PrEP (mean score 2.0 to 3.6, p<0.00). After the trainings, the majority of participants reported feeling ‘comfortable’ or ‘very comfortable’ in determining candidacy for PrEP and prescribing PrEP with follow-up.

Conclusion Implementation of PrEP training courses for OBGYN providers increased knowledge and comfort in identifying and managing patients who may benefit from PrEP services. Increasing training among OBGYN providers serving women at risk for HIV infection is an effective tool to narrow gaps in PrEP access.

  • HIV
  • PREP
  • sexual health
  • gynaecology
  • education

https://doi.org/10.1136/sextrans-2022-055691

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    Footnotes

    • Handling editor Stefano Rusconi

    • Twitter @ARamirezZamudio

    • Contributors FS conducted secondary data analysis, drafted majority of manuscript and made substantial edits to the manuscript. NA helped conceptualise study protocol, drafted materials for the training sessions, conducted primary data analysis and provided insight for manuscript revision. OA helped conceptualise study protocol, draft materials for training session and provided insight for manuscript revision. AEU helped conceptualise study protocol, was the main facilitator for the training sessions and provided insight for manuscript revision. SMD helped conceptualise study protocol and provided insight for manuscript revision. ARZ helped conceptualise study protocol, drafted materials for and led training sessions, assisted in primary and secondary data analysis, and made substantial edits to the manuscript. ARZ is the guarantor for the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.