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Trends in the number and characteristics of HIV preexposure prophylaxis providers in the United States, 2014–2019
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11 01 2021
Source: J Acquir Immune Defic Syndr. 88(3):282-289 -
Alternative Title:J Acquir Immune Defic Syndr
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Description:Background.
The number and characteristics of preexposure prophylaxis (PrEP) healthcare providers in the United States have not been reported.
Methods.
We analyzed a national pharmacy database that included >90% of all prescriptions dispensed by retail pharmacies and 60%–86% dispensed by mail order outlets. We estimated the number of PrEP providers by year, provider type, physician specialty, and geographic location. We also measured Gini coefficients for distribution of PrEP patients among providers.
Results.
The number of PrEP providers increased from 9,621 in 2014 to 65,822 in 2019. In 2019, 68.1% of PrEP providers were physicians. The proportion of nurse practitioners or physician assistants increased from 18.0% in 2014 to 29.7% in 2019. Among all U.S. healthcare providers, those who prescribed PrEP increased from 0.7% in 2014 to 4.3% in 2019. Among all general practice/family medicine physicians, percentage of who prescribed PrEP increased from 1.8% in 2014 to 13.6% in 2019, and from 14.2% to 34.2% among infectious disease physicians. The ratio of PrEP providers to 100 persons with PrEP indications was lowest in the South with 4.4. The Gini coefficient for distribution of PrEP patients among providers was 0.75 in 2019, with 50% of the PrEP patients prescribed PrEP by 2.2% of PrEP providers.
Conclusions.
An increasing number of providers prescribed PrEP during 2014–2019. The South had the largest number of new HIV diagnoses and greatest need for HIV prevention but had less PrEP service capacity compared with other regions. Expanded access to PrEP services is needed in the United States.
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Subject:
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Pubmed ID:34651603
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Pubmed Central ID:PMC8568068
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