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PrEPared-Registered Nurse: Nurse-Led, Community-Based Pre-exposure Prophylaxis Delivery Among Diverse Populations in
Katy Wendel1,2,3, Prerak Shukla1,2,3, Max Wilson1,2,3
1Katy Wendel, DNP, MHA, ACRN, CENP, is the Vice President of Care Delivery Innovation at CAN Community Health, Tampa, Florida, USA.
Abstract:
Pre-exposure prophylaxis (PrEP) coverage remains low among populations most affected by HIV, and U.S. implementation outcomes for nurse-led PrEP delivery under standing orders (physician-authorized protocols permitting registered nurses to perform specified clinical actions) remain minimal. This quasi-experimental study evaluated nurse-led PrEP delivery (N = 197; April 2023-October 2024) across five South Florida sites, using a historical provider-led cohort (N = 561) for context. Female enrollment increased from 12.3% to 24.9%, and heterosexual enrollment from 16.9% to 32.5% (both p < .001). Same-day initiation occurred in 97.0% of encounters; 47.7% persisted on PrEP 6 months or longer, and 56.7% demonstrated adherence. Hispanic/Latino participants showed higher completion than non-Hispanic participants (56.2% vs. 37.0%, p = .011), whereas Black/African American participants showed lower engagement across all outcomes (p < .001) despite comparable enrollment. Findings suggest the model was associated with expanded reach into some underserved populations, alongside disparities requiring targeted engagement.
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