Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309 |
Resumo: | This study aimed to analyze factors associated with the unwillingness to prescribe pre-exposure prophylaxis (PrEP) by health care professionals of specialized HIV/AIDS services. This is a cross-sectional study with 252 health care professionals in 29 specialized care services (SCSs) in HIV/AIDS in 21 municipalities in the state of Bahia, Brazil. The inclusion criterion was that the professional had worked for at least six months in the service. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Logistic regression was performed with an estimation of crude and adjusted odds ratio (OR) and respective 95% confidence intervals (95%CI). The unwillingness to prescribe PrEP was 15.2% (95%CI: 10.8-19.6). The factors associated with unwillingness to prescribe PrEP were non-prescription of HIV self-tests for key populations (adjustedOR = 5.4; 95%CI: 1.3-22.4) nor post-exposure prophylaxis (adjustedOR = 2.00; 95%CI: 1.3-3.1), location of the SCS in the state capital (adjustedOR = 3.9; 95%CI: 1.4-10.2), and SCSs without PrEP offer (adjustedOR = 1.7; 95%CI: 1.1-2.8); professionals who have not reported the need to conduct training and courses (adjustedOR = 1.3; 95%CI: 1.1-1.8), or training with more experienced professionals (adjustedOR = 1.8; 95%CI: 1.1-3.8), was associated with a lower proportion of unwillingness to prescribe PrEP. Our results indicate that health care professionals’ contextual, organizational, and training factors can contribute to PrEP indication. We suggest expanding ongoing training in combined HIV prevention among health care professionals and increasing the availability of PrEP in health services. |
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Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern BrazilResistencia de los profesionales de la salud de los servicios especializados en VIH/SIDA a indicar la PrEP en el Nordeste de BrasilDisposição para oferta de PrEP por profissionais de saúde de serviços especializados HIV/aids no Nordeste do BrasilProfilaxia Pré-ExposiçãoAtitude do Pessoal de SaúdeConhecimentoHIVProfilaxis Pre-ExposiciónActitud del Personal de SaludConocimientoVIHPre-Exposure ProphylaxisAttitude of Health PersonnelKnowledgeHIVThis study aimed to analyze factors associated with the unwillingness to prescribe pre-exposure prophylaxis (PrEP) by health care professionals of specialized HIV/AIDS services. This is a cross-sectional study with 252 health care professionals in 29 specialized care services (SCSs) in HIV/AIDS in 21 municipalities in the state of Bahia, Brazil. The inclusion criterion was that the professional had worked for at least six months in the service. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Logistic regression was performed with an estimation of crude and adjusted odds ratio (OR) and respective 95% confidence intervals (95%CI). The unwillingness to prescribe PrEP was 15.2% (95%CI: 10.8-19.6). The factors associated with unwillingness to prescribe PrEP were non-prescription of HIV self-tests for key populations (adjustedOR = 5.4; 95%CI: 1.3-22.4) nor post-exposure prophylaxis (adjustedOR = 2.00; 95%CI: 1.3-3.1), location of the SCS in the state capital (adjustedOR = 3.9; 95%CI: 1.4-10.2), and SCSs without PrEP offer (adjustedOR = 1.7; 95%CI: 1.1-2.8); professionals who have not reported the need to conduct training and courses (adjustedOR = 1.3; 95%CI: 1.1-1.8), or training with more experienced professionals (adjustedOR = 1.8; 95%CI: 1.1-3.8), was associated with a lower proportion of unwillingness to prescribe PrEP. Our results indicate that health care professionals’ contextual, organizational, and training factors can contribute to PrEP indication. We suggest expanding ongoing training in combined HIV prevention among health care professionals and increasing the availability of PrEP in health services.El objetivo de este estudio fue analizar los factores asociados con la resistencia de los profesionales de la salud de los servicios especializados en VIH/SIDA a prescribir la profilaxis preexposición (PrEP). Se trata de un estudio transversal, realizado con 252 profesionales de la salud de 29 servicios de atención especializada (SAE) en VIH/SIDA en 21 municipios del estado de Bahía, Brasil. Los criterios de inclusión en el estudio fueron tener experiencia laboral de al menos seis meses en el servicio. Los datos sociodemográficos, ocupacionales y conductuales se recogieron mediante cuestionario. Se realizó regresión logística, con estimaciones de odds ratios (OR) cruda y ajustada, con los respectivos intervalos de 95% de confianza (IC95%). La resistencia a prescribir PrEP fue del 15,2% (IC95%: 10,8-19,6). Los factores asociados con la resistencia a prescribir la PrEP fueron no prescribir autopruebas de VIH para poblaciones clave (ORajustada = 5,4; IC95%: 1,3-22,4) ni la profilaxis posexposición (ORajustada = 2,00; IC95%: 1,3-3,1), ubicación del SAE en la capital del estado (ORajustada = 3,9; IC95%: 1,4-10,2) y SAE sin oferta de PrEP (ORajustada = 1,7; IC95%: 1,1-2,8); los profesionales que no reportaron la necesidad de hacer capacitación y cursos (ORajustada = 1,3; IC95%: 1,1-1,8) o capacitación con profesionales con mayor experiencia (ORajustada = 1,8; IC95%: 1,1-3,8) se asociaron con una menor proporción de resistencia a prescribir PrEP. Los resultados indican que los factores contextuales, organizativos y formativos de los profesionales de la salud pueden contribuir a la indicación de la PrEP. Se recomienda que se amplíe la capacitación existente sobre prevención combinada del VIH entre los trabajadores de la salud y aumente la disponibilidad de PrEP en los servicios de salud.O objetivo deste estudo foi analisar fatores associados a não disposição para oferta de profilaxia pré-exposição (PrEP) por profissionais de saúde de serviços especializados em HIV/aids. Este é um estudo transversal, realizado com 252 profissionais de saúde de 29 serviços de atenção especializada (SAEs) em HIV/aids em 21 municípios do Estado da Bahia, Brasil. Para ser incluído no estudo, o profissional precisava estar trabalhando há pelo menos seis meses no serviço. Dados sociodemográficos, ocupacionais e comportamentais foram coletados por meio de questionário. Foi realizada regressão logística, com estimativa de razão de chances (OR) bruta e ajustada, com os respectivos intervalos de 95% de confiança (IC95%). A relutância em prescrever PrEP foi de 15,2% (IC95%: 10,8-19,6). Os fatores associados à relutância em prescrever PrEP foram a não prescrição de autotestes de HIV para populações-chave (ORajustada = 5,4; IC95%: 1,3-22,4) nem profilaxia pós-exposição (ORajustada = 2,00; IC95%: 1,3-3,1), localização do SAE na capital do estado (ORajustada = 3,9; IC95%: 1,4-10,2) e SAE sem oferta de PrEP (ORajustada = 1,7; IC95%: 1,1-2,8); profissionais que não relataram a necessidade de realizar treinamentos e cursos (ORajustada = 1,3; IC95%: 1,1-1,8) ou treinamento com profissionais mais experientes (ORajustada = 1,8; IC95%: 1,1-3,8) foram associados a uma menor proporção de relutância em prescrever PrEP. Nossos resultados indicam que os fatores contextuais, organizacionais e de treinamento dos profissionais de saúde podem contribuir para a indicação da PrEP. Sugerimos expandir o treinamento existente em prevenção combinada ao HIV entre os profissionais de saúde e aumentar a disponibilidade de PrEP nos serviços de saúde.Reports in Public HealthCadernos de Saúde Pública2023-07-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309Reports in Public Health; Vol. 39 No. 13 (2023): Supplement 1Cadernos de Saúde Pública; v. 39 n. 13 (2023): Suplemento 1 1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309/18558https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309/18559Copyright (c) 2023 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessde Souza Lamônica, JulianaMagno Santos de Sousa, LaioElen Jesus da Silva Santos, JuliaInes Costa Dourado, MariaMaia Dos Santos, AdrianoPereira Santos, Marcos2023-08-03T13:58:42Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8309Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:29.527802Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil Resistencia de los profesionales de la salud de los servicios especializados en VIH/SIDA a indicar la PrEP en el Nordeste de Brasil Disposição para oferta de PrEP por profissionais de saúde de serviços especializados HIV/aids no Nordeste do Brasil |
title |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil |
spellingShingle |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil de Souza Lamônica, Juliana Profilaxia Pré-Exposição Atitude do Pessoal de Saúde Conhecimento HIV Profilaxis Pre-Exposición Actitud del Personal de Salud Conocimiento VIH Pre-Exposure Prophylaxis Attitude of Health Personnel Knowledge HIV |
title_short |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil |
title_full |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil |
title_fullStr |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil |
title_full_unstemmed |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil |
title_sort |
Unwillingness to prescribe PrEP by health care professionals of specialized HIV/AIDS services in Northeastern Brazil |
author |
de Souza Lamônica, Juliana |
author_facet |
de Souza Lamônica, Juliana Magno Santos de Sousa, Laio Elen Jesus da Silva Santos, Julia Ines Costa Dourado, Maria Maia Dos Santos, Adriano Pereira Santos, Marcos |
author_role |
author |
author2 |
Magno Santos de Sousa, Laio Elen Jesus da Silva Santos, Julia Ines Costa Dourado, Maria Maia Dos Santos, Adriano Pereira Santos, Marcos |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
de Souza Lamônica, Juliana Magno Santos de Sousa, Laio Elen Jesus da Silva Santos, Julia Ines Costa Dourado, Maria Maia Dos Santos, Adriano Pereira Santos, Marcos |
dc.subject.por.fl_str_mv |
Profilaxia Pré-Exposição Atitude do Pessoal de Saúde Conhecimento HIV Profilaxis Pre-Exposición Actitud del Personal de Salud Conocimiento VIH Pre-Exposure Prophylaxis Attitude of Health Personnel Knowledge HIV |
topic |
Profilaxia Pré-Exposição Atitude do Pessoal de Saúde Conhecimento HIV Profilaxis Pre-Exposición Actitud del Personal de Salud Conocimiento VIH Pre-Exposure Prophylaxis Attitude of Health Personnel Knowledge HIV |
description |
This study aimed to analyze factors associated with the unwillingness to prescribe pre-exposure prophylaxis (PrEP) by health care professionals of specialized HIV/AIDS services. This is a cross-sectional study with 252 health care professionals in 29 specialized care services (SCSs) in HIV/AIDS in 21 municipalities in the state of Bahia, Brazil. The inclusion criterion was that the professional had worked for at least six months in the service. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Logistic regression was performed with an estimation of crude and adjusted odds ratio (OR) and respective 95% confidence intervals (95%CI). The unwillingness to prescribe PrEP was 15.2% (95%CI: 10.8-19.6). The factors associated with unwillingness to prescribe PrEP were non-prescription of HIV self-tests for key populations (adjustedOR = 5.4; 95%CI: 1.3-22.4) nor post-exposure prophylaxis (adjustedOR = 2.00; 95%CI: 1.3-3.1), location of the SCS in the state capital (adjustedOR = 3.9; 95%CI: 1.4-10.2), and SCSs without PrEP offer (adjustedOR = 1.7; 95%CI: 1.1-2.8); professionals who have not reported the need to conduct training and courses (adjustedOR = 1.3; 95%CI: 1.1-1.8), or training with more experienced professionals (adjustedOR = 1.8; 95%CI: 1.1-3.8), was associated with a lower proportion of unwillingness to prescribe PrEP. Our results indicate that health care professionals’ contextual, organizational, and training factors can contribute to PrEP indication. We suggest expanding ongoing training in combined HIV prevention among health care professionals and increasing the availability of PrEP in health services. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-07-02 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309 |
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https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309/18558 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8309/18559 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública info:eu-repo/semantics/openAccess |
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Copyright (c) 2023 Cadernos de Saúde Pública |
eu_rights_str_mv |
openAccess |
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Reports in Public Health Cadernos de Saúde Pública |
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Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 39 No. 13 (2023): Supplement 1 Cadernos de Saúde Pública; v. 39 n. 13 (2023): Suplemento 1 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
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Fundação Oswaldo Cruz (FIOCRUZ) |
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FIOCRUZ |
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FIOCRUZ |
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Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
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cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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