Advancing the case for nurse practitioner‐based models to accelerate scale‐up of HIV pre‐exposure prophylaxis. Issue 1 (11th October 2018) - Nelson, LaRon E.
Abstract: Aims: To explore the factors that position nurse practitioners (NPs) to lead the implementation of HIV pre‐exposure prophylaxis. Background: The HIV epidemic represents a global health crisis. Reducing new HIV infections is a public health priority, especially for Black and Latino men who have sex with men (MSM). When taken as directed, co‐formulated emtricitabine and tenofovir have over 95% efficacy in preventing HIV; however, substantial gaps remain between those who would benefit from pre‐exposure prophylaxis (PrEP) and current PrEP prescribing practices. Design: This is a position paper that draws on concurrent assessments of research literature and advanced practice nursing frameworks. Method: The arguments in this paper are grounded in the current literature on HIV PrEP implementation and evidence of the added value of nurse‐based models in promoting health outcomes. The American Association of Colleges of Nursing's advanced nursing practice competencies were also included as a source of data for identifying and cross‐referencing NP assets that align with HIV PrEP care continuum outcomes. Conclusions: There are four main evidence‐based arguments that can be used to advance policy‐level and practice‐level changes that harness the assets of nurse practitioners in accelerating the scale‐up of HIV PrEP. Relevance to clinical practice: Global public health goals for HIV prevention cannot be achieved without the broader adoption of PrEP as a prevention practice among healthcare providers. NPs are the best hope for closing this gap in access for the populations that are most vulnerable to HIV infection.