{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T14:40:05Z","timestamp":1777732805023,"version":"3.51.4"},"reference-count":64,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["UH1HP30348"],"award-info":[{"award-number":["UH1HP30348"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision. Four overarching barriers presented in the literature: Purview Paradox, Patient Financial Constraints, Risk Compensation, and Concern for ART Resistance. Considering the physician-identified barriers, we make recommendations for how physicians and students may work to increase PrEP knowledge and competence along each stage of the PrEP cascade. We recommend adopting HIV risk assessment as a standard of care, improving physician ability to identify PrEP candidates, improving physician interest and ability in encouraging PrEP uptake, and increasing utilization of continuous care management to ensure retention and adherence to PrEP.<\/jats:p>","DOI":"10.1177\/00469580211017666","type":"journal-article","created":{"date-parts":[[2021,5,22]],"date-time":"2021-05-22T09:18:26Z","timestamp":1621675106000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Recommendations for Increasing Physician Provision of Pre-Exposure Prophylaxis: Implications for Medical Student Training"],"prefix":"10.1177","volume":"58","author":[{"given":"Robert L.","family":"Cooper","sequence":"first","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Juarez","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew C.","family":"Morris","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center, Jackson, MS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aramandla","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Edgerton","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren L.","family":"Brown","sequence":"additional","affiliation":[{"name":"Behavioral Health & Research at Nashville Cares, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leandro","family":"Mena","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center, Jackson, MS, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel A.","family":"MacMaster","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine in Houston, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shavonne","family":"Collins","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia Matthews-","family":"Juarez","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Tabatabai","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine Y.","family":"Brown","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Paul","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wansoo","family":"Im","sequence":"additional","affiliation":[{"name":"Meharry Medical College, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Arcury","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marybeth","family":"Shinn","sequence":"additional","affiliation":[{"name":"Vanderbilt University, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,5,22]]},"reference":[{"key":"bibr1-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0017502"},{"key":"bibr2-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-015-0850-2"},{"key":"bibr3-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3004006"},{"key":"bibr4-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70847-3"},{"key":"bibr5-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2018.06.005"},{"key":"bibr6-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwv202"},{"key":"bibr7-00469580211017666","unstructured":"U.S. CDC. HIV Surveillance Report. CDC; 2013."},{"key":"bibr8-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-008-9508-8"},{"key":"bibr9-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2005.03.023"},{"key":"bibr10-00469580211017666","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph13010030"},{"key":"bibr11-00469580211017666","unstructured":"Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas. 2015. Accessed April 5, 2017. https:\/\/www.cdc.gov\/hiv\/statistics\/overview\/ataglance.html"},{"key":"bibr12-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa318"},{"key":"bibr13-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-010-0043-7"},{"key":"bibr14-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1126\/science.1193748"},{"key":"bibr15-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011205"},{"key":"bibr16-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pctr.0020027"},{"key":"bibr17-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110711"},{"key":"bibr18-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1202614"},{"key":"bibr19-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61127-7"},{"key":"bibr20-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0087674"},{"key":"bibr21-00469580211017666","volume":"7","author":"Okwundu CI","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr22-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"bibr23-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402269"},{"key":"bibr24-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60232-2"},{"key":"bibr25-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e32835369ad"},{"key":"bibr26-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.09.045"},{"key":"bibr27-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.09.047"},{"key":"bibr28-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31824a060b"},{"key":"bibr29-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.09.057"},{"key":"bibr30-00469580211017666","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.21165"},{"key":"bibr31-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2013.0173"},{"key":"bibr32-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2012.0030"},{"key":"bibr33-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2013.845289"},{"key":"bibr34-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0132398"},{"key":"bibr35-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000780"},{"key":"bibr36-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1153595"},{"key":"bibr37-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001182"},{"key":"bibr38-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.01.025"},{"key":"bibr39-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004511"},{"key":"bibr40-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3903-z"},{"key":"bibr41-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156592"},{"key":"bibr42-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1625-1"},{"key":"bibr43-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1612-6"},{"key":"bibr44-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit796"},{"key":"bibr45-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1177\/2325957415600798"},{"key":"bibr46-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0040603"},{"key":"bibr47-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2017.0031"},{"key":"bibr48-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-015-0996-z"},{"key":"bibr49-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2015.0268"},{"key":"bibr50-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2017.0002"},{"key":"bibr51-00469580211017666","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"bibr52-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1337"},{"key":"bibr53-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"bibr54-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00396-2"},{"key":"bibr55-00469580211017666","unstructured":"US Centers for Disease Control and Prevention, US Public Health Service. Preexposure prophylaxis for the prevention of HIV infection in the United States\u20132017 update: a clinical practice guideline. Accessed October 10, 2018. https:\/\/www.cdc.gov\/hiv\/pdf\/risk\/prep\/cdc-hiv-prep-guidelines-2017.pdf"},{"key":"bibr56-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002042"},{"key":"bibr57-00469580211017666","unstructured":"Liu A, Colfax G, Cohen S, et al. The spectrum of engagement in HIV prevention: proposal for a PrEP cascade. In: 7th International Conference on HIV Treatment and Prevention Adherence, Miami Beach, FL, 2012. Accessed April 5, 2021. http:\/\/www.iapac.org\/AdherenceConference\/presentations\/ADH7_80040.pdf"},{"key":"bibr58-00469580211017666","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.130336"},{"key":"bibr59-00469580211017666","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301110"},{"key":"bibr60-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0675-x"},{"key":"bibr61-00469580211017666","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21288"},{"key":"bibr62-00469580211017666","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.174169"},{"issue":"8","key":"bibr63-00469580211017666","first-page":"1211","volume":"211","author":"Lehman DA","year":"2015","journal-title":"J Infect Dis"},{"key":"bibr64-00469580211017666","doi-asserted-by":"publisher","DOI":"10.1177\/1545109709352884"}],"container-title":["INQUIRY: The Journal of Health Care Organization, Provision, and Financing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580211017666","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00469580211017666","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580211017666","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:06:05Z","timestamp":1777460765000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00469580211017666"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":64,"alternative-id":["10.1177\/00469580211017666"],"URL":"https:\/\/doi.org\/10.1177\/00469580211017666","relation":{},"ISSN":["0046-9580","1945-7243"],"issn-type":[{"value":"0046-9580","type":"print"},{"value":"1945-7243","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"00469580211017666"}}