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PrEP- Keyword Analysis
Topics/keywords: ‘PrEP’, ‘pre exposure prophylaxis’
Data types: posts, comments, likes, polls
Geographical segment: global physicians, physicians by region
Analyzed data points on G-Med: 17,865
Specialties: Infectious Disease; HIV Specialists; GPs/Family Medicine; Gynecology
Countries analyzed: 77
Reach: 378,787
Introduction
This report provides an in-depth analysis of physician discussions surrounding pre-exposure prophylaxis (PrEP) for HIV prevention, based on data collected from the G-Med platform. The findings highlight physicians' key concerns, clinical strategies, and opinions related to PrEP, with attention to sentiment breakdowns and cross-country differences. Themes were identified through keyword and content analysis, while sentiment data was extracted from physician language indicating approval, skepticism, or concern.
This report also includes a geographical breakdown and a cross-country thematic comparison, providing clarity on how PrEP-related practices and concerns vary across medical communities globally.
Main Concerns of G-Med Physicians on the Topic of PrEP
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· Access and Cost (21% of physician discussion): The high cost and limited access to PrEP are major concerns, especially in regions with fewer resources or where patients have to pay out of pocket.
o 59% of physicians expressed positive sentiment regarding improved policies and insurance coverage.
o 41% raised concerns over cost barriers, especially in lower-resource settings. (see Figure 1)
· Risk Compensation (19%): There is concern that PrEP might lead to riskier sexual behaviors, with patients potentially neglecting other preventive measures like condom use.
· Efficacy and Adherence (17% of physician discussion): Concerns about PrEP's effectiveness are tied to patient adherence, with inconsistent usage reducing its protective benefits.
o 66% of physician discussions reflected concern about PrEP efficacy due to poor adherence or inconsistent use.
o 34% expressed positive sentiment, highlighting its effectiveness when patients follow prescribed regimens strictly.
· Side Effects and Safety (11%): Physicians worry about potential side effects, particularly renal injury and bone density loss, with questions about long-term safety.
Main Points Concerning HIV/AIDS Diagnosis, Treatment, and Follow-up in Relation to PrEP
Diagnosis (30% of physician discussions)
Pre-PrEP HIV Testing (18%): Physicians emphasize the critical need for confirming a patient’s HIV-negative status before starting PrEP. Physicians advise one another that this step is vital to ensure that individuals who may have undetected acute HIV infection are not inadvertently placed on PrEP, which could lead to suboptimal treatment and drug resistance.
Regular HIV Testing (13%): Continuous HIV testing is a key focus, with recommendations for frequent testing (every 3 months) while on PrEP. This practice ensures that any seroconversion is detected early, allowing for immediate transition to appropriate HIV treatment.
Acute HIV Symptoms Monitoring (12%): Physicians discuss the importance of educating patients about the symptoms of acute HIV infection and advising them to seek immediate testing if they experience any symptoms, even if they have been adherent to PrEP.
Treatment (36% of physician discussions)
Transition to ART (4%): If a patient on PrEP contracts HIV, physicians stress the importance of a swift transition from PrEP to a full antiretroviral therapy (ART) regimen. This is crucial to prevent the development of drug-resistant HIV strains.
Drug Resistance Concerns (3%): There is concern about the potential for drug resistance in patients who start PrEP while unknowingly HIV-positive or who become HIV-positive while on PrEP.
Management of Breakthrough Infections: Physicians also discuss the management of breakthrough infections, where patients on PrEP contract HIV, although rare, tried to seek answers to understand why PrEP failed.
Follow-up (18% of physician discussions)
Side Effects Management (15%): Physicians discuss the need for proactive management of side effects, such as renal function decline or bone density loss, asking questions on whether they should adjust the treatment plan or explore alternative prevention strategies.
Routine Monitoring (5%): Regular follow-up visits are essential for monitoring the patient's health, adherence to PrEP, and any potential side effects. Physicians recommend that these visits occur every 3 months and include comprehensive assessments, including screening for other STIs, renal function tests and pregnancy tests in women, in line with current guidelines and recommendations.
Counseling and Education (4%): Continuous education and counseling during follow-up visits is emphasized to reinforce the importance of adherence and address any concerns or misconceptions patients might have about PrEP.
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Geographical Differences in Physicians’ PrEP Concerns by Region or Country
North America: Physicians in North America are primarily concerned with issues of adherence and the long-term safety of PrEP. They also discuss the implications of PrEP on public health strategies for HIV prevention, including its role in reducing HIV incidence in high-risk populations.
Europe: In Europe, discussions often focus on the accessibility and cost of PrEP. Physicians express concerns about the inconsistent availability of PrEP across different countries and the need for more robust public health policies to support its widespread use.
Africa: Physicians from African countries highlight the challenges of PrEP implementation in resource-limited settings. They are particularly concerned with ensuring equitable access to PrEP and the need for community education to address cultural stigmas and patient adherence.
Asia: In Asia, physicians discuss the integration of PrEP into existing HIV prevention programs and the need for more research on its effectiveness in local populations. Concerns about cultural acceptance and the potential for increased risky behaviors are also prevalent.
These insights can help tailor communication and support strategies for physicians in different regions, addressing their specific concerns and focal points more effectively.
Cross-Country Differences in PrEP-Related Approaches
Follow-Up Protocols: Physicians in Canada, the UK, and Germany discussed structured, standardized follow-up every 3 months, while the US, Brazil, and Israel emphasized more personalized follow-up based on individual risk and side effects.
Attitudes Toward Adherence and Efficacy: US, Spain, and UK physicians voiced more skepticism around real-world effectiveness tied to adherence; French and German physicians expressed greater confidence when adherence is ensured.
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Engagement Recommendations:
As can be seen from the report, there are some knowledge gaps on the topic of PrEP, especially surrounding long-term effects and drug resistance. An awareness campaign could be beneficial in this case, as well as a traffic-driving campaign in cases where there is a brand dot com.
G-Med's Awareness Package or Traffic-Driving Package could be a good fit here.