Yale University

The impact of patient race on clinical decisions related to prescribing HIV pre-exposure prophylaxis (PrEP): assumptions about sexual risk compensation and implications for access.

TitleThe impact of patient race on clinical decisions related to prescribing HIV pre-exposure prophylaxis (PrEP): assumptions about sexual risk compensation and implications for access.
Publication TypeJournal Article
Year of Publication2014
AuthorsCalabrese, Sarah K., Valerie A. Earnshaw, Kristen Underhill, Nathan B. Hansen, and John F. Dovidio
JournalAIDS and behavior
Volume18
Issue2
Pagination226-40
Date Published2014 Feb
ISSN1573-3254
KeywordsAdult, African Continental Ancestry Group, Anti-HIV Agents, Antibiotic Prophylaxis, Attitude of Health Personnel, Cultural Competency, Decision Making, Drug Prescriptions, European Continental Ancestry Group, Health Care Surveys, Health Knowledge, Attitudes, Practice, Health Personnel, Health Services Accessibility, HIV Infections, Homosexuality, Male, Humans, Male, Prejudice, Questionnaires, Racism, Socioeconomic Factors, Students, Medical
AbstractAntiretroviral pre-exposure prophylaxis (PrEP) has received increasing recognition as a viable prescription-based intervention for people at risk for HIV acquisition. However, little is known about racial biases affecting healthcare providers' willingness to prescribe PrEP. This investigation sought to explore medical students' stereotypes about sexual risk compensation among Black versus White men who have sex with men seeking PrEP, and the impact of such stereotypes on willingness to prescribe PrEP. An online survey presented participants (n = 102) with a clinical vignette of a PrEP-seeking, HIV-negative man with an HIV-positive male partner. Patient race was systematically manipulated. Participants reported predictions about patient sexual risk compensation, willingness to prescribe PrEP, and other clinical judgments. Bootstrapping analyses revealed that the Black patient was rated as more likely than the White patient to engage in increased unprotected sex if prescribed PrEP, which, in turn, was associated with reduced willingness to prescribe PrEP to the patient.
DOI10.1007/s10461-013-0675-x
Alternate JournalAIDS Behav

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