Buprenorphine Prescribers Providing HIV Pre-Exposure Prophylaxis


Led by former Clinician-Researcher Fellow Dr. Amy Kennedy and mentoring author Dr. Jessica Merlin, with qualitative expertise from Dr. Megan Hamm, a pilot study was recently published as letter to the editor for the Journal of Addiction Medicine. The authors investigated buprenorphine prescribers’ knowledge, barriers, and facilitators regarding preexposure prophylaxis (PrEP) for HIV prevention among people who inject drugs.

The team conducted semi-structured interviews with 5 different practices for a total of 13 buprenorphine prescribers—only 2 two of whom had previously prescribed PrEP for a patient receiving buprenorphine.

“We decided to utilize qualitative research methods for this study as we were interested in understanding the detailed reasons for why buprenorphine providers may or may not prescribe HIV PrEP for their patients,” stated Dr. Kennedy.

The qualitative analysis revealed five themes:

  1. Provider experience with PrEP is limited.
  2. PrEP is relevant to patients on buprenorphine, but not a priority to prescribers.
  3. Targeting the right population of “high risk” patients is important.
  4. Barriers to PrEP are multifactorial.
  5. With certain facilitators in place, PrEP implementation is possible.

“While some of our themes were expected, we were most surprised that PrEP was not a priority to buprenorphine prescribers,” stated Dr. Kennedy. “Further studies should focus on ways to easily implement PrEP screening and implementation into primarily care settings.” 

These pilot results suggest future educational interventions and more studies with larger samples that also include patient perspectives.

In addition to the previously mentioned CRHC contributors, other co-authors from the University of Pittsburgh School of Medicine were Flor de Abril Cameron, MPH; Valerie Gobao; and Ken Ho, MD. Outside of Pitt, collaborators included Iman Hassan, MD, MS (Albert Einstein College of Medicine); E. Jennifer Edelman, MD, MHS (Yale School of Public Health); and Stuart Fisk, CRNP (Allegheny Health Network).

November 25, 2020  • Michelle Woods