TY  - JOUR
AU  - Ding, Haibo
AU  - Ye, Zehao
AU  - Tang, Weiming
AU  - Huang, Xiaojie
AU  - Wang, Hui
AU  - Cui, Sitong
AU  - Jiang, Yongjun
AU  - Geng, Wenqing
AU  - Xu, Junjie
AU  - Shang, Hong
PY  - 2021
DA  - 2021/3/11
TI  - Context and Barriers to the Prescription of Nonoccupational Postexposure Prophylaxis Among HIV Medical Care Providers: National Internet-Based Observational Study in China
JO  - JMIR Public Health Surveill
SP  - e24234
VL  - 7
IS  - 3
KW  - WeChat
KW  - nonoccupational postexposure prophylaxis (nPEP)
KW  - HIV medical care providers
KW  - training
KW  - key populations
KW  - internet
KW  - China
KW  - social media
KW  - barrier
KW  - prophylaxis
AB  - Background: Nonoccupational postexposure prophylaxis (nPEP) is an effective HIV biomedical prevention strategy. The research and use of nPEP are mainly concentrated in the developed world, while little is known about the knowledge, attitudes, and practices of nPEP among HIV medical care providers in developing countries. Objective: We aimed to assess the nPEP knowledge and prescribing practice among HIV medical care providers in mainland China. Methods: HIV medical care providers were recruited in China during May and 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: A total of 777 eligible participants participated in this study from 133 cities in 31 provinces in China. Of the participants, 60.2% (468/777) were unfamiliar with nPEP and only 53.3% (414/777) of participants ever prescribed nPEP. HIV care providers who worked in a specialized infectious disease hospital (vs general hospital, adjusted odds ratio [aOR] 2.49; 95% CI 1.85-3.37), had practiced for 6-10 years (vs 5 or fewer years, aOR 3.28; 95% CI 2.23-4.80), had practiced for 11 years or more (vs 5 or fewer years, aOR 3.75; 95% CI 2.59-5.45), and had previously prescribed occupational PEP (oPEP, aOR 4.90; 95% CI 3.29-7.29) had a significantly positive association with prescribing nPEP. However, unfamiliarity with nPEP (aOR 0.08; 95% CI 0.05-0.11), believing nPEP may promote HIV high-risk behavior (aOR 0.53; 95% CI 0.36-0.77) or result in HIV drug resistance (aOR 0.53; 95% CI 0.36-0.77) among key populations, and self-reported having no written oPEP guideline in place (aOR 0.53; 95% CI 0.35-0.79) were negatively associated with nPEP prescription behavior. Conclusions: HIV medical care providers have insufficient nPEP knowledge and an inadequate proportion of prescribing, which may impede the scale-up of nPEP services to curb HIV acquisition. The implementation of tailored nPEP training or retraining to HIV medical care providers would improve this situation. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2021/3/e24234
UR  - https://doi.org/10.2196/24234
UR  - http://www.ncbi.nlm.nih.gov/pubmed/33704078
DO  - 10.2196/24234
ID  - info:doi/10.2196/24234
ER  -