Abstract:

Condom use remains the predominant prophylactic intervention to control rates of human immunodeficiency virus (HIV) infection. However, chemoprophylactic strategies, which involve pre-exposure prophyaxis (PrEP) and post-exposure prophyaxis (PEP), have emerged as appropriate prevention tools to minimise and prevent future infections. Different studies have indicated that PrEP can prevent new HIV infections among men who have sex with men when used daily or event-based, and it is also effective with heterosexuals and people who inject drugs. However, appropriate education is needed as recent reports have observed a decline in adherence to PrEP over time, particularly in young adults, which will impact on the effectiveness of PrEP. Thus, we created a brief educational short intervention (3 hours) to increase the awareness of HIV with second year BMedSci Medical Science (Hons) students at De Montfort University (DMU, UK) in 2016/17 (Peña-Fernández et al., 2017). Briefly, BMedSci students tailored a community-centred intervention programme to reduce HIV infection rates following evidence-based public health methodology. 92% indicated an acquisition of knowledge for preventing HIV transmission and tools to fight this disease. However, BMedSci students also showed a lack of knowledge of preventative measures (PrEP and PEP), routes of transmission and appropriate screening. We implemented a similar teaching strategy with BSc Biomedical Science (BMS) students enrolled in the level 4 module of Basic Microbiology in 2017/18, but limited to two hours: one-hour lecture and one hour workshop in which different HIV prevention strategies were discussed and analysed by students. BMS students were also provided with an overview about the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90:90:90 targets in the UK (2016). In a similar way as with the BMedSci cohort, BMS students showed little awareness about PEP/PrEP, specifically knowledge about what are they/how they work, access and usage. This teaching intervention was well-received by students according to the feedback provided in the final module level feedback. BMS participants (n=27 out of 187 students) indicated that they enjoyed the session and suggested a practical session and the introduction of case studies to enhance the teaching intervention. We are developing a virtual clinical case study on HIV following recent successful experiences in the development and introduction of these novel learning strategies and have performed small modifications in the delivery of this workshop for 2018/19 to increase engagement and interaction. In conclusion, we consider that similar short education interventions that specifically target HIV chemoprophylaxis would be needed in any degree to prevent the decline in adherence to PrEP over time observed in young adults and reduce PEP/PrEP stigma and other barriers which could impede their access.

Keywords:

HIV, chemical prophylaxis, PrEP, preventive education.