UNIVERSITY PARK, Pa. — Jocelyn Anderson, assistant professor and researcher, was recently awarded a National Institute of Mental Health (NIMH) grant for her research study titled "Development of a patient-provider decision aid for HIV Post-Exposure Prophylaxis (PEP)."
In conjunction with co-principal investigator (PI) Jessica Draughon Moret, assistant professor of clinical nursing at the University of California Davis, Anderson is developing, refining and piloting an app-based, multimedia decision aid to support individuals who have been exposed to HIV, with special consideration to victims of sexual violence. The decision aid will assist medical providers in more effectively implementing HIV PEP by helping patients better understand the HIV PEP treatment option.
HIV PEP is a prescribed medicine taken orally for 28 days to prevent HIV after possible exposure to the virus and is intended to be started within 72 hours after the exposure. However, due to communication variability and priority disconnect between provider and patient, implementation of the HIV PEP medication has shown to be inconsistent, according to the researchers.
The app-based multimedia tool is being formulated off the basis of eliminating provider biases; presenting concise information to improve the process of information sharing and decisionmaking; and incorporating an opportunity for patients to reflect on key priorities shown to impact decision-making and adherence (e.g., social support/stigma, HIV risk perception, cost/access, side effects).
Using these core foundations, the decision aid will provide a structured and neutral script for medical providers to follow and give patients a comprehensive explanation of HIV, risk factors, HIV PEP, and the ability to rank their medical priorities, such as whether they feel their mental health following a sexual assault is more important than taking HIV PEP, or vice versa. Keeping in mind these priorities, the provider can then tailor their communication to the patient more effectively, and in turn the medication, said the researchers.
“Through our clinical practice, as well as working with others, we have seen how those conversations happen and how protocols from the CDC (Centers for Disease Control) leave a lot of that discussion and decisionmaking up to the individual provider,” said Anderson. “We have been looking at some of the challenges in those discussions, and our goal is to build the app-based tool to help facilitate those conversations and provide standardized education for patient decisionmaking.”
HIV PEP is an underutilized and understudied tool in the current HIV epidemic, said the researchers. Successfully improving HIV PEP implementation is one step in improving care and outcomes for a highly marginalized group of individuals at risk for HIV.
Anderson and Draughon Moret anticipate that the multimedia decision aid will help allow patients to experience less decisional conflict and, in turn, make completion of the entire 28-day medication more likely for patients who chose to initiate the HIV PEP option. Upon a successful research phase, the pair said they hope to implement the tool on a national, large-scale basis.