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AIDS and Behavior
Published in: AIDS and Behavior 5/2020

Open Access 01-05-2020 | Post-Exposure Prophylaxis | Original Paper

Active-Offer Nurse-Led PrEP (PrEP-RN) Referrals: Analysis of Uptake Rates and Reasons for Declining

Authors: Patrick O’Byrne, Lauren Orser, Marlene Haines

Published in: AIDS and Behavior | Issue 5/2020

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Abstract

While pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, its uptake is limited. To address barriers, we piloted a nurse-led PrEP clinic in an STI clinic and had public health nurses refer patients during STI follow-up. We recorded the number of PrEP offers and declines and clinic uptake. We conducted a thematic analysis of patients’ responses from nursing notes written at the time patients declined PrEP. From August 6, 2018 to August 5, 2019, nurses offered a PrEP referral to 261 patients who met our criteria; only 47.5% accepted. Qualitative analysis identified four themes: (1) perceptions of risk, (2) lack of interest, (3) inability to manage, and (4) concerns about PrEP. Our patients did not feel sufficiently at-risk for HIV to use PrEP and maintained that PrEP was for a reckless “other”. This analysis sheds light on how assumptions about risk affect PrEP uptake, particularly among those at-risk for HIV.
Footnotes
1
While most persons achieve an undetectable viral load within 6 months of treatment, we used 12 months because it encompasses not only the period of medication initiation to viral load suppression (often 6 months), but also the time from diagnosis to referral to care to medication initiation (which can range from days to another few months).
 
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Metadata
Title
Active-Offer Nurse-Led PrEP (PrEP-RN) Referrals: Analysis of Uptake Rates and Reasons for Declining
Authors
Patrick O’Byrne
Lauren Orser
Marlene Haines
Publication date
01-05-2020
Publisher
Springer US
Published in
AIDS and Behavior / Issue 5/2020
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02745-9

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