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. 2019 May-Jun;30(3):301-311.
doi: 10.1097/JNC.0000000000000075.

PrEP-RN: Clinical Considerations and Protocols for Nurse-Led PrEP

Patrick OʼByrne, Paul MacPherson, Lauren Orser, Jean Daniel Jacob, Dave Holmes

PrEP-RN: Clinical Considerations and Protocols for Nurse-Led PrEP

Patrick OʼByrne et al. J Assoc Nurses AIDS Care. 2019 May-Jun.

Abstract

HIV pre-exposure prophylaxis (PrEP) is an increasingly important part of the HIV prevention armamentarium. Issues with PrEP, however, include access. We propose that one way to surmount this issue would be to have nurses provide PrEP. Although clinical guidelines exist for PrEP, they are overwhelmingly not targeted to nonprescriber clinicians. In this article, we overview current U.S. and Canadian PrEP guidelines and provide explicit guidance about how nurses can provide PrEP, including the clinical pathways and medical directives we use in our clinic. We call nurse-led provision of PrEP, PrEP-RN (Pre-Exposure Prophylaxis-Registered Nurse) and feel it may be an important step forward in HIV prevention.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
HIV risk stratification. Note. ACB = African, Caribbean, Black communities; IDU = injection drug use; MSM = men who have sex with men; PEP = postexposure prophylaxis; STI = sexually transmitted infection.
Figure 2.
Figure 2.
Estimated glomerular filtration rate management pathway for first visit. Note. eGFR = estimated glomerular filtration rate; FTC/TDF = 300 mg emtricitabine (FTC) plus 200 mg tenofovir disoproxil fumarate; ID = infectious diseases; LSC = last sexual contact; PEP = postexposure prophylaxis; SeCr = serum creatinine; WNL = within normal limits.
Figure 3.
Figure 3.
Estimated glomerular filtration rate management pathway for follow-up visits. Note. eGFR = estimated glomerular filtration rate; FEP = fractional excretion of phosphate; FTC/TDF = 300 mg emtricitabine (FTC) plus 200 mg tenofovir disoproxil fumarate; FU = follow-up; ID = infectious diseases; LSC = last sexual contact; PEP = pre-exposure prophylaxis; SeCr = serum creatinine; ULN = upper limit of normal; WNL = within normal limits.
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References

    1. Aghaizu A., Tosswill J., De Angelis D., Ward H., Hughes G., Murphy G., Delpech V. (2018). HIV incidence among sexual health clinic attendees in England: First estimates for black African heterosexuals using a biomarker, 2009–2013. PLoS One, 13(6), 1-14. 10.1371/journal.pone.0197939 - DOI - PMC - PubMed
    1. Anderson P. L., Glidden D. V., Liu A., Buchbinder S., Lama J. R., Guarnira J. V., Grant R. M. (2012). Emtricitabine-tenofovir exposure and pre-exposure prophylaxis efficacy in men who have sex with men. Science Translational Medicine, 4(151),151ra125. 10.1126/scitranslmed.3004006 - DOI - PMC - PubMed
    1. Brown A. E., Mohammed H., Ogaz D., Kirwan P. D., Yung M., Nash S. G., Gill O. N. (2017). Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: Testing or treatment or pre-exposure prophylaxis (PrEP)? Eye Science, 22(25), 30553. 10.2807/1560-7917.ES.2017.22.25.30553 - DOI - PMC - PubMed
    1. Canadian Institutes of Health Information. (2017). Regulated Nurses, 2017. Retrieved from https://www.cihi.ca/en/regulated-nurses-2017-infographic
    1. Canadian National Advisory Committee on Immunization. (2018). Canadian immunization guide: Part 4 – active vaccines. Human papillomavirus. Retrieved from https://www.canada.ca/en/public-health/services/publications/healthy-liv...

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