Evidence map›Paper›PMID 28574774›Full record

ArticleAIDS patient care and STDs2017

Differing Experiences with Pre-Exposure Prophylaxis in Boston Among Lesbian, Gay, Bisexual, and Transgender Specialists and Generalists in Primary Care: Implications for Scale-Up.

Douglas S Krakower, Norma C Ware, Kevin M Maloney, Ira B Wilson, John B Wong, Kenneth H Mayer

Abstract read
In one paragraph

Article in AIDS patient care and STDs, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.

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  17. US Guideline Criteria for Human Immunodeficiency Virus Preexposure Prophylaxis: Clinical Considerations and Caveats.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Douglas S Krakower1 Division of Infectious Diseases, Beth Israel Deaconess Medical Center , Boston, Massachusetts.
Norma C Ware3 Department of Global Health and Social Medicine, Harvard Medical School , Boston, Massachusetts.
Kevin M Maloney1 Division of Infectious Diseases, Beth Israel Deaconess Medical Center , Boston, Massachusetts.
Ira B Wilson4 Division of Health Services, Policy and Practice, Brown University , Providence, Rhode Island.
John B Wong5 Division of Clinical Decision Making, Tufts Medical Center, Tufts University School of Medicine , Boston, Massachusetts.
Kenneth H Mayer1 Division of Infectious Diseases, Beth Israel Deaconess Medical Center , Boston, Massachusetts.
Beth Israel Deaconess Medical Center · USBrown University · USHarvard University · USTufts University · US

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ROBERT A. PARKER · 2004 to 2026
$94.4M
Tracking and Evaluation CoreU54GM115677 · NIGMS · BROWN UNIVERSITY · PI ROUNDS, SHARON IRENE SMITH · 2016 to 2025
$45.0M
Improving the diagnosis and treatment of medication adherence problems in HIVK24MH092242 · NIMH · BROWN UNIVERSITY · PI WILSON, IRA B · 2010 to 2014
$937k
Optimizing HIV Pre-Exposure Prophylaxis through Shared Decision MakingK23MH098795 · NIMH · BETH ISRAEL DEACONESS MEDICAL CENTER · PI KRAKOWER, DOUGLAS SCOTT · 2012 to 2016
$873k
NIAID NIH HHS P30 AI060354NIGMS NIH HHS U54 GM115677NIMH NIH HHS K23 MH098795NIMH NIH HHS K24 MH092242
6 · The paper itself

Abstract

The Centers for Disease Control and Prevention estimates that one in four sexually active men who have sex with men (MSM) could decrease their HIV risk by using HIV pre-exposure prophylaxis (PrEP). Because many MSM access healthcare from primary care providers (PCPs), these clinicians could play an important role in providing access to PrEP. Semistructured qualitative interviews were conducted with 31 PCPs in Boston, MA, to explore how they approach decisions about prescribing PrEP to MSM and their experiences with PrEP provision. Purposive sampling included 12 PCPs from an urban community health center specializing in the care of lesbian, gay, bisexual, and transgender persons ("LGBT specialists") and 19 PCPs from a general academic medical center ("generalists"). Analyses utilized an inductive approach to identify emergent themes. Both groups of PCPs approached prescribing decisions about PrEP as a process of informed decision-making with patients. Providers would defer to patients' preferences if they were unsure about the appropriateness of PrEP. LGBT specialists and generalists were at vastly different stages of adopting PrEP into practice. For LGBT specialists, PrEP was a disruptive innovation that rapidly became normative in practice. Generalists had limited experience with PrEP; however, they desired succinct decision-support tools to help them achieve proficiency, because they considered preventive medicine to be central to their professional role. As generalists vastly outnumber LGBT specialists in the United States, interventions to support PrEP provision by generalists could accelerate the scale-up of PrEP for MSM nationally, which could in turn decrease HIV incidence for this priority population.

Indexed as

Practice Patterns, Physicians'Pre-Exposure ProphylaxisPrimary Health CareSexual and Gender MinoritiesAdultAnti-HIV AgentsBostonCommunity Health CentersFemaleHealth Services AccessibilityHIV InfectionsHumansInterviews as TopicMaleMiddle AgedPhysiciansAnti-HIV AgentsHIVmen who have sex with menpre-exposure prophylaxisprimary care providersqualitative research

Identifiers

PMID28574774
PMCPMC5512323
OpenAlexW2620967096

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.