Pre-exposure prophylaxis, or PrEP, is a combination of two HIV medicines taken daily by those who are at a high risk of contracting the virus, including people who don't always use condoms when having sex with high-risk partners and anyone who injects illicit drugs. It is a lifesaving, effective treatment.
When taken regularly, PrEP drastically reduces the chances of HIV infection. Yet nearly a third of medical students—future doctors who could prescribe it—don't know about it. Worse yet, many don't believe it's effective.
That's according to a new survey of 1,588 medical students at 18 US medical schools. Of those students, 28 percent didn't know about PrEP; 18 percent in their last year of school had never been taught about it. This is, again, a highly effective HIV prevention regimen. Yet 57 percent of students surveyed thought behavioral intervention—convincing patients to live differently—should be tried before prescribing PrEP. (Studies show that, actually, PrEP is more effective than trying to change behaviors.)
Another 45 percent believed patients wouldn't consistently take the medicine, which experts say shouldn't be a reason not to prescribe it. Finally, 22 percent simply didn't think PrEP was effective.
Those are pretty damning numbers, raising questions about preparedness among the next wave of healthcare providers. "Medical students are not being taught about PrEP as they should and therefore are unaware of it, or have inaccurate beliefs about its value," Brandon Imp, lead author of the study, said in a statement. "That is concerning because they are the next generation of physicians who will provide care to patients and help stem the spread of the disease. These results demonstrate the need to incorporate PrEP education into the medical school curriculum."
Unfortunately, it's not just med students who don't know the facts about PrEP. A separate study of healthcare providers at a Boston hospital found that one-third had never heard of it. Among doctors, 32 percent said they were uncomfortable prescribing it. Some said they preferred to refer patients to specialists, who might be better trained to assess risk. Doing so, though, could mean missing an opportunity to start PrEP as early as possible. It also puts the onus on patients to follow up with a specialist they may not know or trust.
PrEP works. It's already preventing infections and saving lives. But there's much more to be done. "Fewer than 10 percent of people who would benefit from PrEP are taking it," Imp said. "We believe education works, but we need to do a better job throughout the country to inform future doctors as well as health providers who are on the front lines of care about the benefits of PrEP."
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