Using community-engaged intervention mapping, the authors developed and pretested PrEP-Pro, an intervention to support family medicine physician-trainees in eliciting sexual histories from and prescribing PrEP to adolescents, with special emphasis on Black adolescent girls and young women, finding high acceptability, appropriateness, and feasibility scores.
PrEP-Pro demonstrated high acceptability, appropriateness, and feasibility scores in a 3-month pretest across two family medicine residency programs.
The provider Community Advisory Board (CAB) recommended seven distinct training strategy components for the PrEP-Pro intervention.
The AGYW Community Advisory Board specifically informed development of a sexual history screener and clinic posters emphasizing confidentiality for adolescent clients.
Post-pretest interviews with six physicians identified needed adaptations to the intervention.
The intervention was developed using community-engaged intervention mapping with input from two focus group discussions with physicians.
High HIV incidence in the US South disproportionately affects adolescents, young adults, and Black women, providing the epidemiological rationale for the intervention.
This research describes the development and initial testing of PrEP-Pro, a training program designed to help family medicine doctors-in-training in Alabama have conversations about sexual health and prescribe HIV prevention medication (PrEP) to teenagers. The program was built with direct input from two advisory groups: one made up of healthcare providers and PrEP advocates, and another made up of adolescent girls and young women, with a particular focus on Black young women who face disproportionately high rates of HIV in the American South. The training includes videos, reference cards, educational materials, a patient screening tool, and clinic posters that emphasize patient confidentiality. When tested at two family medicine training clinics over three months with eight physicians, the program received high ratings for acceptability, appropriateness, and feasibility — all averaging above 4 out of 5. Follow-up interviews with six of the physicians led to further improvements, including more hands-on case-based learning, building a shared learning community among doctors, and refining the quick-reference cards. These refinements were incorporated before the program was rolled out more broadly. This research suggests that a community-designed, theory-based training program can be well-received by physician trainees learning to provide HIV prevention care to adolescents. The study is a preparatory step toward a larger clinical trial and highlights the value of including both healthcare providers and the communities most affected by HIV — particularly Black adolescent girls and young women — in designing medical education interventions.
Pratt M, Isehunwa O, Hill S, Simpson T, Lanzi R, Van Wagoner N, et al.. (2025). Adapting an Intervention to Improve Adolescent Sexual Health Assessment and Pre-Exposure Prophylaxis Prescription by Family Medicine Physicians in Alabama.. AIDS patient care and STDs. https://doi.org/10.1089/apc.2025.0064