Aisha King, MPH
Nominated From: University of Washington
Research Site: Asociacion Civil Impacta Salud y Educacion (IMPACTA)
Research Area: HIV, health care professionals, PrEP, DoxyPEP, attitudes
Primary Mentor: Dr. Ann Duerr
Research Project
Provider knowledge and attitudes regarding PrEP and DoxyPEP in Peru: Exploring how to support the implementation of Peru’s 2023 national HIV prevention guidelines
Lifetime prevalence of HIV among men who have sex with men (MSM) and transgender women (TW) in Peru remains high, estimated at 10-20%. Tenofovir-based Pre-Exposure Prophylaxis (PrEP) is an effective method to reduce HIV transmission that has recently been adopted into Peru’s national HIV prevention guidelines. The success of these guidelines to reduce HIV incidence will depend on the engagement of providers, as healthcare providers’ recommendations are a significant motivating factor for PrEP uptake, adherence, and long-term engagement among MSM and TW in Peru. However, little is known about current PrEP-related knowledge among providers in Peru and misconceptions about PrEP remain widespread globally. Current government trainings provide only operational information on guideline implementation and as such may be missing a key opportunity to address misconceptions about PrEP and populations at highest risk of acquiring HIV. In order to support the implementation of the new national HIV/STI prevention guidelines, this study has three objectives: 1) to characterize providers’ knowledge of, attitudes towards, and willingness to prescribe PrEP to priority populations; 2) to explore providers’ understanding of ‘DoxyPEP,’ (Doxycycline Post-Exposure Prophylaxis), which was recently shown to reduce acquisition of bacterial sexually transmitted infections among MSM and TW; and 3) to develop PrEP- and DoxyPEP- related training materials to be shared with local NGOs that serve MSM and TW. The final curriculum will be guided by data collected through a web-based survey among providers and 12 in-depth interviews with a diverse group of providers.
Research Significance
In a recent interview, Dr. Carlos Benites, the executive director of the HIV/STI and prevention office at the Ministry of Health, cited provider resistance as a key barrier to PrEP implementation and highlighted the need for more provider training. The present research and deliverables will therefore be instrumental in supporting the rollout of PrEP in Peru and ultimately reducing HIV incidence. Furthermore, this study will be the first to examine provider attitudes and knowledge of DoxyPEP in Peru, which may help reduce acquisition of bacterial STIs among MSM and TW. Lastly, this work can provide a roadmap for the implementation of national HIV/STI prevention programs in other LMICs by demonstrating the importance of integrating accurate information about PrEP and DoxyPEP into guidelines and provider trainings. There are still many countries that have yet to adopt PrEP and DoxyPEP on a national level. By deepening our understanding of providers’ relationship with HIV/STI prevention, training programs will be able to better address providers’ concerns, support effective prescription practices, and ultimately reduce the incidence of HIV and bacterial STIs.
Publications
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