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Clinical Considerations and Protocols for Nurse-Led PrEP

Journal of the Association of Nurses in AIDS Care: May-June 2019 - Volume 30 - Issue 3 - p e5–e6
doi: 10.1097/JNC.0000000000000092


  • Read the article on page 301.
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DOI: 10.1097/JNC.0000000000000092

Purpose: To provide information about how nurses can provide pre-exposure prophylaxis (PrEP-RN) in sexually transmitted infection (STI) clinics.

Learning Objectives/Outcomes: After completing this continuing education activity, you should be able to:

  • 1. Identify the epidemiology of HIV infection and issues related to PrEP.
  • 2. Specify how nurses can provide PrEP in an outpatient STI clinic.
  • 1. The only medication approved for PrEP in the U.S. and Canada is the fixed combination of emtricitabine (FTC) plus tenofovir disoproxil fumarate (TDF) in which doses?
    • a. 200 mg FTC + 150 mg TDF
    • b. 300 mg FTC + 200 mg TDF
    • c. 400 mg FTC + 250 mg TDF
  • 2. In the 2015 study by Pathela et al., more than 1 in 20 men were diagnosed with HIV within 1 year of a diagnosis of
    • a. syphilis.
    • b. chlamydia.
    • c. human papillomavirus.
  • 3. According to the Centers for Disease Control and Prevention (2018), the rates of HIV acquisition are higher in what group compared to other populations that are affected by HIV?
    • a. transgender persons
    • b. men who have sex with men (MSM)
    • c. persons who share injection drug paraphernalia
  • 4. In the U.S. in 2016, the rate of HIV infection among women in which ethnic communities was disproportionately higher than for females of other ethnicities?
    • a. Native American, Alaskan Native, and Native Hawaiian
    • b. Hispanic, Latina
    • c. African, Caribbean, Black
  • 5. According to the PrEP-RN model described in this article, persons who should be actively offered PrEP include all of the following except
    • a. anyone after post-exposure prophylaxis (PEP) use.
    • b. persons from global endemic areas.
    • c. MSM with rectal gonorrhea.
  • 6. A targeted approach recommended by the authors to increase PrEP awareness is
    • a. using mass media strategies.
    • b. placing brochures in public restrooms.
    • c. educating staff in STI clinics about PrEP.
  • 7. At the first clinic visit, the authors note that patients should be assessed for symptoms of acute HIV infection that they have at the visit and in the preceding 4 weeks, such as
    • a. myalgias.
    • b. nonproductive cough.
    • c. conjunctivitis.
  • 8. Known contraindications to FTC/TDF include
    • a. estimated glomerular filtration rate (eGFR) > 60 mL/min.
    • b. elevated liver enzyme levels.
    • c. HIV-positive status.
  • 9. Serology testing at the first clinic visit includes testing for
    • a. gonorrhea.
    • b. chlamydia.
    • c. hepatitis A, B, and C.
  • 10. According to the PrEP-RN model, what laboratory test is used to calculate an eGFR?
    • a. albumin
    • b. creatinine
    • c. blood urea nitrogen
  • 11. The model used in this article calculates the eGFR using the more accurate
    • a. Chronic Kidney Disease Epidemiology (CKD-Epi) Collaboration formula.
    • b. Cockcroft-Gault formula.
    • c. Modification of Diet in Renal Disease (MDRD) Study formula.
  • 12. Risk reduction counseling for patients who will be starting PrEP include all of the following except the
    • a. use of PEP for missed FTC/TDF doses.
    • b. fact that PrEP is effective with or without condom use.
    • c. importance of safer drug use equipment.
  • 13. The first prescription for FTC/TDF in the PrEP-RN model is for
    • a. 1 month.
    • b. 2 months.
    • c. 3 months.
  • 14. According to the eGFR management pathway for the 1st visit, if the eGFR is <60 mL/min and the last sexual contact (LSC) was >3 days ago, what is the next step?
    • a. If the LSC was high risk, page infectious diseases practitioner on-call for referral in <24 hours.
    • b. Prescribe FTC/TDF.
    • c. No action is indicated.
  • 15. Side effects from FTC/TDF include
    • a. dry mouth.
    • b. insomnia.
    • c. bloating.
  • 16. After the initial prescription, patients who follow the PrEP-RN program have clinic visits every
    • a. month.
    • b. 3 months.
    • c. 6 months.
  • 17. In the PrEP-RN model at the clinic described in this article, how long are services provided before patients are referred to an external provider for continuation of care?
    • a. 6 to 12 months
    • b. 14 to 16 months
    • c. 18 to 24 months
  • 18. Research by O’Byrne, et al. (2017) revealed that a total of how many patients who completed a single course of PEP went on to acquire HIV within 12 months due to a new exposure to HIV not treated with PEP?
    • a. 9%
    • b. 12%
    • c. 15%
© 2019 Association of Nurses in AIDS Care