ArticleJournal of general internal medicine2020
Roadblocks to PrEP: What Medical Records Reveal About Access to HIV Pre-exposure Prophylaxis.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
What it found
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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.
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.
Who cites it
29 citing papers in PubMed, 43 citations in OpenAlex.
- Rural providers' attitudes toward integrating harm reduction strategies and PrEP prescribing into rural primary care settings in the US. Southeast and Midwest.Addiction science & clinical practice · 2025Article
- The Lifecycle of Electronic Health Record Data in HIV-Related Big Data Studies: Qualitative Study of Bias Instances and Potential Opportunities for Minimization.Journal of medical Internet research · 2025Article
- A Scoping Review of Methodological Approaches to Detect Bias in the Electronic Health Record.Stigma and health · 2025Article
- A Multicomponent Strategy to Improve HIV Pre-Exposure Prophylaxis in a Southern US Jail: Protocol for a Type 3 Hybrid Implementation-Effectiveness Trial.JMIR research protocols · 2025Article
- Clustering affordable care act qualified health plans to understand how and where insurance facilitates or impedes access to HIV prevention.AIDS research and therapy · 2024Article
- Sexually Transmitted Infection (STI) Incidence, STI Screening, and Human Immunodeficiency Virus Preexposure Prophylaxis Uptake in United States Veterans With Opioid Use Disorder in Long Island, New York.Open forum infectious diseases · 2024Article
- Need for informed providers: exploring LA-PrEP access in focus groups with PrEP-indicated communities in Baltimore, Maryland.BMC public health · 2024Article
- Implementing an Automated Prediction Model to Improve Prescribing of HIV Preexposure Prophylaxis.NEJM catalyst innovations in care delivery · 2023Article
- Geographic Variation in Qualified Health Plan Coverage and Prior Authorization Requirements for HIV Preexposure Prophylaxis.JAMA network open · 2023Article
- Individual and Health System Factors for Uptake of Pre-exposure Prophylaxis Among Young Black and Latino Gay Men.Journal of general internal medicine · 2023Article
- Missed Opportunities When We Focus only on Risk: Using the Concerns Based Conversation Starter to Identify Potential PrEP Candidates.AIDS and behavior · 2023Article
- Successful Integration of HIV PrEP in Primary Care and Women's Health Clinical Practice: A Model for Implementation.Viruses · 2023Article
- Article
- Usability and Utility of Human Immunodeficiency Virus Pre-exposure Prophylaxis Clinical Decision Support to Increase Knowledge and Pre-exposure Prophylaxis Initiations among Pediatric Providers.Applied clinical informatics · 2022Article
- Discussion and Initiation of HIV Pre-exposure Prophylaxis Were Rare Following Diagnoses of Sexually Transmitted Infections Among Veterans.Journal of general internal medicine · 2022Article
- "Let's Be a Person to Person and Have a Genuine Conversation": Comparing Perspectives on PrEP and Sexual Health Communication Between Black Sexual Minority Men and Healthcare Providers.Archives of sexual behavior · 2022Article
- Article
- PrEP Familiarity, Interest, and Usage Among 364 Black and Hispanic Adults in Indiana.Frontiers in public health · 2022Article
- Tailored HIV Pre-exposure Prophylaxis (PrEP) Intervention Needs from a Latent Class Analysis Among U.S. Healthcare Providers.AIDS and behavior · 2021Article
- Patient-Led Decision-Making for HIV Preexposure Prophylaxis.Current HIV/AIDS reports · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPre-exposure prophylaxis (PrEP) has been shown to be efficacious in preventing HIV; however, its uptake remains modest. Given that there are fewer cost barriers to receiving PrEP within VHA than via commercial insurance, VHA represents an ideal setting in which to study other barriers that may impact patients seeking PrEP.
objectiveWe sought to understand potential barriers to obtaining PrEP within the Veterans Health Administration (VHA) through examination of documentation in electronic medical records.
designRetrospective structured chart review, including chart abstractions of notes, referrals, and communications; content analysis of charts from a subsample of patients receiving PrEP in VHA.
participantsOne hundred sixty-one patients prescribed PrEP at 90 sites varying in PrEP prescribing rates. APPROACH: We extracted descriptive information and conducted a qualitative analysis of all PrEP-relevant free-text notes including who initiated the PrEP conversation (patient vs. provider), time interval between request and prescription, reasons for denying PrEP, and patient responses to barriers. KEY
resultsPatients initiated 94% of PrEP conversations and 35% of patients experienced delays receiving PrEP ranging from six weeks to 16 months. Over 70% of cases evidenced barriers to access. Barriers included provider knowledge gaps about PrEP, provider knowledge gaps about VHA systems related to PrEP, confusion or disagreement over clinic purview for PrEP, and provider attitudes or stigma associated with patients seeking PrEP.
conclusionsAlthough PrEP is recommended for HIV prevention in high-risk persons, many PrEP-eligible individuals faced barriers to obtaining a prescription. Current practices place substantial responsibility on patients to request and advocate for this service, in contrast to many other preventive services. Understanding the prevalence and content of PrEP knowledge gaps and attitudinal barriers can inform organizational interventions to increase PrEP access and decrease HIV transmission.
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What OpenQuestion holds
Registered trials
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.