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AIDS Behav (2014) 18:226240 DOI 10.1007/s10461-013-0675-x
ORIGINAL PAPER
The Impact of Patient Race on Clinical Decisions Related to Prescribing HIV Pre-Exposure Prophylaxis (PrEP): Assumptions About Sexual Risk Compensationand Implications for Access
Sarah K. Calabrese Valerie A. Earnshaw
Kristen Underhill Nathan B. Hansen
John F. Dovidio
Published online: 24 December 2013 Springer Science+Business Media New York 2013
Abstract Antiretroviral 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.
Resumen La prolaxis pre-exposicin con antirretrovirales (PrEP) ha recibido cada vez ms reconocimiento como intervencin viable a base de receta para personas en riesgo de contraer el VIH. Sin embargo, se conoce poco acerca de los prejuicios raciales que afectan a la disposicin de los proveedores de salud a prescribir PrEP. Esta investigacin busc explorar los estereotipos de los estudiantes de medicina sobre la compensacin del riesgo sexual entre hombres negros versus hombres blancos que tienen sexo con hombres que solicitan la PrEP, y el impacto de esos estereotipos sobre la voluntad de prescribir PrEP. Una encuesta por Internet present a los participantes (n = 102) una vieta clnica de una peticin de PrEP; un hombre sin VIH con una pareja masculina seropositiva. La raza del paciente fue manipulada sistemticamente. Los participantes informaron de las predicciones de la compensacin del riesgo del paciente, de la voluntad de prescribir PrEP, y de otros juicios clnicos. Anlisis de muestreo revelaron que el paciente negro fue clasicado como ms propenso...