Exploring nurse‐led HIV Pre‐Exposure Prophylaxis in a community health care clinic

• Published in: Public health Nursing 2020-11, Vol.37 (6), p.871-879
• Main Authors: Selfridge, Marion, Card, Kiffer G., Lundgren, Karen, Barnett, Tamara, Guarasci, Kellie, Drost, Anne, Gray‐Schleihauf, Christiane, Milne, Roz, Degenhardt, Jonathan, Stark, Aeron, Hull, Mark, Fraser, Chris, Lachowsky, Nathan J.
• Format: Article
• Language: English
• Subjects: Bisexuality; Canada; Community health care; Community Health Services; Demographics; Demography; Disease prevention; Exposure; Gays & lesbians; gbMSM; Health care facilities; Health risks; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV/AIDS; Homosexuality, Male; Human immunodeficiency virus; Humans; Male; men's health; Mens health; Nurse's Role; nurse‐led; Pre-Exposure Prophylaxis - methods; PrEP; Prophylaxis; Public health; Retrospective Studies; Risk perception; Sexual and Gender Minorities; Sexually transmitted diseases; STD
• ISSN: 0737-1209; 1525-1446
• DOI: 10.1111/phn.12813

Objectives Gay, bisexual, and other men who have sex with men (gbMSM) are 131 times more likely to acquire HIV compared with other Canadian men. Pre‐Exposure Prophylaxis (PrEP) for HIV has the potential to reduce or eliminate disparities in HIV acquisition among key affected populations. This paper aims to discuss the feasibility and utility of a nurse‐led PrEP program administered by the Cool Aid Community Health Centre (CACHC) in Victoria, British Columbia as a public health PrEP program was initiated. Design, Sample and Measurements A retrospective chart review of 124 gbMSM patients accessing PrEP at CACHC in 2018 collected information on patient demographics, STI testing results, and PrEP prescription pick‐ups at 3 time points. Results Ninety‐nine (79.8%) patients have continued on PrEP, as defined as having picked up their second 90‐day PrEP prescription. Both older age and having an Sexually Transmitted Infection after PrEP enrolment were significantly associated with staying on PrEP; decreased risk perceptions contributed most to clinic‐level discontinuance. Very few patients who stayed on PrEP have transitioned to their own General Practitioner. Conclusions Patients appear to recognize their risk and are continuing on PrEP to reduce their risk of HIV. As evidenced by ability to recruit and maintain patients, we conclude that nurse‐led PrEP at community health centres supports access and uptake of essential health services to optimize individual and population health.