A Preliminary Study of the Attitudes and Barriers of Family Physicians to Prescribing HIV Preexposure Prophylaxis

Introduction. Attitudes of individuals who provide HIV caretowards prescribing Preexposure Prophylaxis (PrEP) to at-riskpopulations have been studied, but few studies indicate if familyphysicians would be willing to prescribe PrEP as most familyphysicians do not specialize in HIV medicine. Few data existon the perceived barriers preventing family physicians fromprescribing PrEP. The purpose of this project was to assess theattitudes and perceived barriers of family physicians in Kansastowards prescribing PrEP to high risk patient populations. Methods. This study was a descriptive, observational,and cross-sectional survey of family physicians who respondto email surveys issued through the Family MedicineResearch and Data Information Office (FM RADIO). Results. Fifty-three percent of family physicians take a sexualhistory on new patients less than frequently, and only35% frequently ask about the use of safe sex practices. Only29% frequently ask if the patient has sex with men, women,or both. Seventy-six percent of respondents would be willingto prescribe PrEP to men who have sex with men, and anequal percentage would be willing to prescribe to heterosexuallyactive men and women who are at substantial risk of acquiringHIV. While 59% of participants agreed that PrEP belongsin the primary care domain of treatment, 71% agreedthat they had limited or no knowledge of PrEP guidelines. Conclusions. This preliminary study indicated a need for increasedfamily physician screening of new patients for high risksexual behaviors who would be eligible for PrEP. The limitedknowledge of PrEP guidelines and its use in clinical practiceare significant limiting factors to increasing prescribing practicesin the family medicine community rather than a perceivedethical dilemma of prescribing PrEP to men who have sex withmen. As a result, an increase in continuing medical educationabout PrEP could significantly increase its prescribing inthe family medicine community. KS J Med 2017;10(2):40-42

A Qualitative Study of Traditional Bone Setters in South India: A Case Series

INTRODUCTION. There are approximately 70,000 Traditional Bone Setters (TBS) in India, who have no formal education or training in modern medicine but treat approximately 60% of bone related trauma. This study investigated the history of TBS, why they are so popular, and their methods. METHODS. From a list of TBS from four states in South India, a purposive and convenience sampling method identified participants. One lead TBS from each state was interviewed. With recommendations from these TBS, a total of six participants were interviewed on Zoom® in their native dialect and these interviews were transcribed into English. The data were analyzed using a constant comparative method which included several iterations to refine common themes and determine counterfactual and specific focal points from each interview. RESULTS. Six overarching themes emerged: (1) history of traditional bone setters, (2) occupations outside bone setting, (3) training, certification, education, accolades, (4) patient characteristics and success stories, (5) infrastructure and approach to diagnosis/treatment, and (6) limitations of practice, challenges, and social relevance. The history of traditional bone setting is thousands of years old and passed down within families generationally. CONCLUSIONS. In rural India, where a large part of the population lives in poverty and without access to modern medicine, traditional healers provide a much-needed service, often without charge, and consequently, the income is not sufficient without other occupations such as farming. They follow a similar approach to diagnosis and treatment of simple fractures and dislocations as modern medical practitioners. Most would like to share their knowledge and collaborate with ayurvedic and allopathic practitioners and simply want to be respected and supported