These medical students want to give PrEP to all the wrong people

Researcher says new doctors need more education and less implicit bias

Medical students in the US are less willing to prescribe PrEP to men who are at highest risk for HIV infection, according to a recent study.

George Washington University psychologist Sarah Calabrese asked more than 100 medical students to consider if they would prescribe PrEP, drugs shown to be highly effective at preventing the transmission of HIV, to various hypothetical men. Some of the imaginary patients were in a relationship with an HIV-positive man, while some had multiple partners of unknown status. Some used condoms, some did not, and some planned to stop using condoms after taking PrEP.

When the imaginary patients were at low risk – used condoms and planned to keep using them – about 90 percent of the students said they would prescribe PrEP. But only half the students were willing to prescribe PrEP to a patient who consistently did not use condoms, and only a quarter said they were willing to prescribe to a patient who would stop using condoms once on PrEP.

The students also were slightly less likely to prescribe PrEP to men who had multiple partners.

This pattern is antithetical to where PrEP is actually most useful.

“If you are using condoms, if you know the status of your partner, if your partner’s HIV is suppressed, you don’t need Truvada,” researcher Julio Montaner at the BC Centre for Excellence in HIV/AIDS told Xtra when the PrEP drug Truvada was approved by Health Canada this spring.

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