Investigating biomedical HIV prevention approach for HIV negative patients : Oral PrEP (Pre-exposure Prophylaxis) from a nursing perspective

This research study aims to shed light on the biomedical approach to HIV prevention and in particular PrEP is investigated. Three research questions sought to answer the role of PrEP plays in HIV prevention, the challenges regarding PrEP that a nurse faces when encountering patients of high risk of HIV and how those problems can be solved. The study adopts the HIV prevention continuum model by Horn T et al. (2016). Only half of the model for HIV negative patients was used which was the primary HIV prevention process that focuses on HIV testing, risk and needs assessment; linkage to prevention services as well as retention, engagement and adherence. A literature review based on secondary data was carried out for investigating the research questions. By adopting inclusion and exclusion criteria for the keywords chosen for data collection, 10 articles were selected from 235 items across a variety of scientific databases. The keywords used for selection criteria are PrEP, HIV, HIV prevention, Oral pre-exposure Prophylaxis, Nursing, Healthcare Providers, and Transgender. All articles were filtered to be after 2012 since that was the year the FDA approved PrEP. After data collection, inductive approach of qualitative content analysis by Graneheim & Lundman (2004) was used for data analysis. The findings manifest that PrEP is effective in HIV prevention for those vulnerable to the infection which, to name a few, are MSM, Transgender, heterosexual women, IDUs, sex workers and those in discordant relationships. Moreover, there were challenges regarding PrEP faced by both the patients and the HCPs. The typically identified challenges were adherence, cost, mistrust, drug resistance, risk compensation, etc. The measures taken to counteract these obstacles that nurses should adopt as discussed, are thorough need & risks assessment, referring the patients to HIV prevention services like mental health services, STI clinics, specific community, etc. In addition, nurses are recommended to build trust with the patients, provide accurate information about PrEP, set reminders such as phone calls and text messages for pill taking and follow up, provide feedback and counseling as well as cooperating with social workers. One of the limitations of this study is that HIV prevention methods are predicted to change in the future which may supercede some concepts described in this paper. More research is recommended to look at the model by Horn T et al. (2016) as a whole and/or incorporate the concepts of behavioral interventions, biomedical interventions and structural interventions into the study