An exploratory study of physicians’ familiarity, knowledge, and willingness to prescribe pre-exposure prophylaxis in the MENA region

Pre-exposure prophylaxis (PrEP) is among the most effective tools used for HIV prevention. Primary care providers (PCPs) play a crucial role in identifying people at risk and initiating care. There is a gap in research on PrEP use in the MENA region; this study aims to assess PCPs' knowledge, familiarity with PrEP and willingness to prescribe it. An online survey targeted PCPs and infectious disease (ID) specialists across the MENA region, with most responses coming from Lebanon. Data included demographics, practice characteristics, perceived knowledge, familiarity with PrEP, willingness to prescribe it, and barriers. Descriptive statistics and bivariate analysis were applied to compare groups. Seventy-five providers responded, sex ratio nearly 1:1, most being PCPs. ID specialists more often treated STIs and cared for people living with HIV than PCPs (p = 0.003 and p < 0.001, respectively). 40% rated themselves "somewhat unfamiliar/unfamiliar" with PrEP, and only 24% felt confident answering patients' questions. While 73% were willing to prescribe PrEP, 64% had never done so. More PCPs (78.3%) than ID specialists (19.6%) had never prescribed PrEP (p = 0.005). Barriers to prescribing PrEP included lack of knowledge, financial coverage (p < 0.001), governmental policy regulating PrEP use (p < 0.001), and counselling time (all p < 0.001). Findings highlight significant gaps in knowledge and practice, particularly among PCPs, despite high willingness to prescribe. Coordinated efforts involving education, policy, and financial support are essential to expand PrEP implementation in the region.