Three out of four infectious disease physicians in the United States and Canada support the use of HIV antiretrovirals (ARVs) as pre-exposure prophylaxis (PrEP), yet a scant 9 percent report prescribing to HIV-negative patients this method of HIV prevention, aidsmap reports. Publishing their findings in the online edition of Clinical Infectious Diseases, investigators conducted the largest-ever survey of attitudes toward PrEP among clinicians.

In June 2013, the researchers gave a questionnaire to 1,175 physician members of the Infectious Disease Society of America’s (IDSA) Emerging Infections Network (EIN). The survey’s response rate was 49 percent. Seventy-four percent of the responding clinicians supported PrEP, while 14 percent were unsure and 12 percent were unsupportive.

Nine percent reported prescribing PrEP. Forty-three percent said that while they had not yet written a prescription for the therapy they would do so. Thirty-four percent said that PrEP was not relevant to their patient population.

Reasons for doctors’ lack of support for prescribing PrEP included worries about how their patients would adhere to the therapy, and whether drug resistance may come about. There were also worries about the drug’s cost and insurance coverage, about giving a potentially toxic medication to HIV-negative people, and concerns about PrEP’s efficacy in preventing HIV transmission. Some were also worried about risk compensation among their patients—the phenomenon of people engaging in more risky behaviors because of an intervention that otherwise lowers their risk, likely mitigating if not canceling out the benefit of the intervention.

To read the aidsmap story, click here.

To read the study abstract, click here.