PrEP Providers Have Increased Significantly Across the United States Since 2014

The number of US health care providers who prescribe pre-exposure prophylaxis (PrEP) increased nearly 7-fold from 2014 to 2019, according to new data.

Despite having fewer PrEP providers than other regions, the South had the largest number of new diagnoses of HIV infection and the greatest need to prevent HIV infection.

To determine the number and characteristics of PrEP providers in the United States, researchers in the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention analyzed data from a national pharmacy database. The database included more than 90% of all prescriptions dispensed by retail pharmacies and 60% to 80% of those dispensed by mail-order pharmacies.

This data was used to estimate the number of PrEP providers by year, as well as their type, physician specialty, and location. The researchers also measured the Gini coefficients for the distribution of patients needing PrEP vs the number of PrEP providers.

The results of the analysis showed that, from 2014 to 2019, the number of PrEP providers had increased nearly 7-fold, from 9621 to 65,822 and that the proportion of all US health care providers who prescribed PrEP increased 6-fold, from 0.7% to 4.3%.

In 2019, nearly 30% of nurse practitioners or physician assistants were PrEP providers, which represents an increase of nearly 12% from 2014, when this proportion was 18%. Nevertheless, in 2019, most PrEP providers, or nearly 70%, were physicians. 

Regarding provider breakdown by physician specialty, for general practice or family medicine physicians, the proportion of PrEP providers also increased 7-fold, from nearly 2% in 2014 to nearly 14% in 2019. For infectious diseases specialists, this proportion more than doubled, from 14% in 2014 to 34% in 2019.

In addition, the researchers found that the distribution of PrEP patients vs providers was lowest in the South, at 4.4 PrEP providers per 100 persons with indications for PrEP. However, despite having less capacity to provide PrEP than other regions, this region also had the largest number of new HIV diagnoses and the greatest need for HIV prevention.

The researchers concluded that, despite the increase in the number of PrEP providers from 2014 to 2019, “Expanded access to PrEP services is needed in the United States,” particularly in the South.

—Ellen Kurek

Reference:

Zhu W, Huang YLA, Kourtis AP, Hoover KW. Trends in the number and characteristics of HIV pre-exposure prophylaxis providers in the United States, 2014–2019. J Acquir Immune Defic Syndr. 2021;88(3):282-283. https://doi.org/10.1097/qai.0000000000002774