Adolescent Medicine Physician Attitudes Toward the Use of Topical Microbicides and Oral Pre-Exposure Prophylaxis (Prep) For HIV Prevention in Youth

An abstract of a study by Kowalczyk Mullins et al examining attitudes among physicians providing primary care to adolescents, a prescriber group likely to provide HIV prevention to at-risk youth. Results showed that physicians viewed topical microbicides more favorably than oral PrEP; physicians perceived that topical agents would have fewer side effects (n=5), fit easier into current practice (n=3), be unlikely to be associated with HIV viral resistance (n=2), and be more amenable to prescribing without the need to involve parents (n=2). Perceived benefits of prescribing oral PrEP and topical microbicides were similar, including decreased acquisition of HIV, empowering patients with regard to control of their own reproductive health, improving patient knowledge about HIV, and improving provision of sexual health services. Perceived barriers to prescribing topical microbicides included concerns about cost (n=6), side effects (n=5), access to prescribers and product (n=5), risk compensation (n=4), and acceptability to patients (n=3). More physicians reported preference for parental involvement in the prescription of oral PrEP vs. topical microbicide (6 vs. 2). While 6 (75%) physicians reported being highly or somewhat likely to recommend or prescribe topical microbicides, 4 (50%) physicians reported the same likelihood of recommending or prescribing oral PrEP.