A Cross-sectional Survey of Internal Medicine Resident Knowledge, Attitudes, Behaviors, and Experiences Regarding Pre-Exposure Prophylaxis for HIV Infection

Christopher Terndrup, Carl G. Streed, Perry Tiberio, Marissa Black, John Davis, Ariella Apfel, Oni J. Blackstock, E. Jennifer Edelman, Gail Berkenblit

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Background: Pre-exposure prophylaxis (PrEP) for HIV is effective, yet many providers continue to lack knowledge and comfort in providing this intervention. It remains unclear whether internal medicine (IM) residents receive appropriate training in PrEP care and if this affects their future practices. Objective: We sought to evaluate the relationship between current IM residents’ prior PrEP training and knowledge, comfort, and practice regarding the provision of PrEP. Design and Participants: We created an online survey to assess IM residents’ knowledge, attitudes, and behaviors related to PrEP. The survey was distributed among five IM programs across the USA. Key Results: We had a 35% response rate. Of 229 respondents, 96% (n = 220) had heard of PrEP but only 25% (n = 51) had received prior training and 11% (n = 24) had prescribed PrEP. Compared with those without, those with prior training reported good to excellent knowledge scores regarding PrEP (80% versus 33%, p < 0.001), more frequent prescribing (28% versus 7%, p = 0.001), and higher comfort levels with evaluating risk for HIV, educating patients, and monitoring aspects of PrEP (75% versus 26%, 56% versus 16%, and 47% versus 8%, respectively; all p values < 0.0001). While only 25% (n = 51) had received prior training, 75% (n = 103) of respondents reported that training all providers at their continuity clinic sites would improve implementation. Conclusions: We found that prior training was associated with higher levels of self-reported PrEP knowledge, comfort, and prescribing behaviors. Given the significant need for PrEP, IM residents should be trained to achieve adequate knowledge and comfort levels to prescribe it. This study demonstrates that providing appropriate PrEP training for IM residents may lead to an increase in the pool of graduating IM residents prescribing PrEP.

Original languageEnglish (US)
JournalJournal of general internal medicine
StatePublished - Jan 1 2019



  • HIV pre-exposure prophylaxis
  • resident education

ASJC Scopus subject areas

  • Internal Medicine

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