Assessing the Potential for Nurse-Led HIV Pre- and Postexposure Prophylaxis in Ontario

Abstract

Background and purpose

HIV prevention efforts in Ontario require increased implementation of strategies including post- and pre-exposure prophylaxis. Access to these interventions could be improved by their provision through nurse-led models of care. We assessed nurses’ readiness to deliver these interventions using a behavioral change framework.

Methods

We distributed an online survey to nurses in every Ontario sexual health clinic, HIV clinic, and community health center between March-June 2018, to determine the level of support for nurse-led postexposure prophylaxis/pre-exposure prophylaxis; we also explored nurses’ “capabilities,” “opportunities,” and “motivations” for providing postexposure prophylaxis/pre-exposure prophylaxis.

Results

Overall, 72.7% of respondents supported implementation of both nurse-led postexposure prophylaxis and pre-exposure prophylaxis. More experienced nurses were less likely to support nurse-led postexposure prophylaxis and pre-exposure prophylaxis (adjusted odds ratio = 0.55 per decade nursing, 95% confidence interval (0.37, 0.82)). Nurses reported a high degree of knowledge of topics related to postexposure prophylaxis/pre-exposure prophylaxis, with the exception of creatinine interpretation.

Conclusions

Ontario nurses report high levels of support for nurse-led postexposure prophylaxis and pre-exposure prophylaxis and are well positioned to provide these interventions. Targeted education and implementation efforts are needed to engage these nurses in postexposure prophylaxis and pre-exposure prophylaxis delivery.

Keywords

Behavior change HIV prevention implementation science nursing

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