PrEP in Italy: The time may be ripe but who’s paying the bill? A nationwide survey on physicians’ attitudes towards using antiretrovirals to prevent HIV infection

Antonio Di Biagio, Niccolò Riccardi, Alessio Signori, Renato Maserati, Silvia Nozza, Andrea Gori, Stefano Bonora, Marco Borderi, Diego Ripamonti, Maria Cristina Rossi, Giancarlo Orofino, Tiziana Quirino, Giuseppe Nunnari, Benedetto Maurizio Celesia, Salvatore Martini, Caterina Sagnelli, Giovanni Mazzola, Pietro Colletti, Dario Bartolozzi, Teresa BiniNicoletta Ladisa, Filippo Castelnuovo, Annalisa Saracino, Sergio Lo Caputo

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Abstract

Several studies have demonstrated the efficacy of the oral pre-exposure prophylaxis (PrEP) with tenofovir (with or without emtricitabine) on preventing HIV-negative partners of HIV infected patients to become infected through sexual contacts. PrEP is already available in the United States and now is approved by European Medicine Agency. In this setting we would like to gauge physicians’ knowledge, acquaintance with and attitude to include PrEP in their clinical practice. A cross sectional survey was conducted among Italian physicians expert on antiretroviral therapy. Out of 146 physicians, 35% of participants declared to be familiar with PrEP but only 46% of them believed that, currently, there are not enough reasons to make it available in Italy. 51% of physicians have already been attracted to prescribe it and 63.4% have been openly asked about PrEP. The main concerns noticed were: the risk of acquire other sexual transmitted diseases (STDs) (70% of physicians feared that PrEP could favor STDs spread), the potential harmful of PrEP if not adequately implemented and, especially the risk of possible side effects if not properly used. Nevertheless, 55.9% of participants believed that Health Authorities face an ethical obligation to make PrEP available as part of the strategies to protect from HIV transmission and half of the respondents asked for further researches to better define the role for PrEP. Attitudes regarding PrEP impact on Italian National Health Organization were also very interesting: 57.5% of participants did not believe that investing in PrEP would be an appropriate use of healthcare resources, while 70.6% affirmed that PrEP’s financial coverage should not be funded by the Italian National System of Health (SSN). This survey showed a high awareness of PrEP potential among Italian physicians coupled with a great deal of skepticism about how and if implementing it in clinical practice.

Original languageEnglish
Article numbere0181433
JournalPLoS One
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

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ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Di Biagio, A., Riccardi, N., Signori, A., Maserati, R., Nozza, S., Gori, A., Bonora, S., Borderi, M., Ripamonti, D., Rossi, M. C., Orofino, G., Quirino, T., Nunnari, G., Celesia, B. M., Martini, S., Sagnelli, C., Mazzola, G., Colletti, P., Bartolozzi, D., ... Lo Caputo, S. (2017). PrEP in Italy: The time may be ripe but who’s paying the bill? A nationwide survey on physicians’ attitudes towards using antiretrovirals to prevent HIV infection. PLoS One, 12(7), [e0181433]. https://doi.org/10.1371/journal.pone.0181433