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. 2020 May;24(5):1281-1289.
doi: 10.1007/s10461-019-02745-9.

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

Patrick O'Byrne  1   2 , Lauren Orser  3   4 , Marlene Haines  3
Affiliations

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

Patrick O'Byrne et al. AIDS Behav. 2020 May.

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.

Keywords: HIV; Nursing; PrEP; Prevention.

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