PrEP-RN: Clinical Considerations and Protocols for Nurse-Led PrEP.
Patrick OʼByrne, Paul MacPherson, Lauren Orser and 2 others
PMID 31008817WHAT IT FOUND
A proposed nurse-led PrEP pathway in STI clinics would use baseline testing, kidney checks, counseling, two visits to start, then monthly and three-month monitoring.
Preliminary data from one clinic reported nine early syphilis cases.
Key findings
01The proposed PrEP-RN pathway would have nurses provide PrEP in STI clinics after an initial visit, an initiation visit 1 to 2 weeks later, a 1-month follow-up, and follow-up every 3 months.
02In preliminary data from the authors' local PrEP clinic, 108 patients were followed; 85% had routine syphilis screening, 87% of those who had this testing did so every 3 months, and nine new syphilis cases were identified at an early stage.
03Of 84 MSM who completed a single course of PEP in a nurse-led program, 9% went on to acquire HIV within 12 months due to ongoing risks and exposures; these diagnoses were not PEP failures.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a proposed service model, not a controlled study, so it does not show that nurse-led PrEP works. The preliminary data are descriptive counts from the authors' clinics and do not compare nurse-led PrEP with usual care. No formal methods, randomisation, blinding, or outcome analysis are reported. The protocol depends on local medical directives, laboratory pathways, drug stock, and referral arrangements that may not exist elsewhere. Tables and figures are not available, so some pathway details cannot be checked.
Declared interests
The article's disclosure section reports no real or perceived vested interests. The supplied publication types note research support from a non-U.S. government source.
The easy way to misread this
Do not read this as proof that nurse-led PrEP reduces HIV or STI transmission. It is a proposed protocol and descriptive preliminary data, not a controlled trial. The nine early syphilis cases came from routine testing within the service, not from PrEP medication alone.