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Pre-exposure prophylaxis (PrEP) is a growing comprehensive preventive care regimen that can be taken by a human immunodeficiency virus (HIV) negative person before potential HIV exposure. It is “believed that PrEP is a critically important tool that must be a part of all efforts to end the HIV/AIDS epidemic in the United States” (Human Rights Campaign, n.d.).

The Human Rights Campaign (n.d.) states “while HIV affects Americans from all walks of life, the virus continues to disproportionately impact members of the lesbian, gay, bisexual, and transgender (LGBT) community. For example, almost two-thirds of new HIV infections are among gay and bisexual men”. PrEP was the first drug approved by the Federal Drug Administration in 2012 to reduce the risk of HIV infection. The Centers for Disease Control (and Prevention (CDC) (2016) states “when taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are high risk by up to 92%”.

Project Inform (2016) states "in clinical studies, when people whose primary exposure was through receptive anal sex had blood levels of Truvada showing near daily use, the level of protection was up to 99%" (p. 7).

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hiv infection (disease or medical condition)

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PrEP means pre-exposure prophylaxis, and it's the use of medication - a pill each day - to protect you from HIV. Here's what you need to know about it.

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Nursing informatics influences every area of nursing practice. By providing education on new advances in health technology like the use of PrEP, nurses will play a critical role in PrEP implementation.

Treston, Farley, Harris, Hoyt, Kwong and Van Nuys (2015) state "nurses are trained to be leaders and advocates for change and have the opportunity to play a role in PrEP implementation. For example, nurses play a key role in implementation and evaluation of new programs, staff training, and infrastructure function. As more people become aware of PrEP, we must ensure that there are adequate numbers of capable providers available to educate, prescribe, support, and monitor patients who choose PrEP. Nurses in various settings must understand their communities and patient risk profiles and decide if establishing a PrEP program is appropriate" (p. 224).

Furthermore, Treston et al., (2015) states "Nurse practioners in various settings must become familiar with prescribing and monitoring PrEP. Familiarity with the U.S. Public Health Service guidelines (CDC, 2014), accompanying clinicians’ supplement, and the Clinician Consultation Center hotline (http://nccc.ucsf.edu) is important. As Sowicz et al. (2014) pointed out, registered nurses have the ability to bridge the gap between patients and prescribers and are important in educating patients and colleagues about PrEP. Nurses, particularly those practicing in STI, GYN, and primary care settings, can engage patients in dialogue based on HIV riskscreening tools to identify patients who may benefit from PrEP. PrEP requires routine lab work and counseling follow-up. Nurses can manage these visits and collaborate with prescribers to develop standing orders for laboratory testing and medication refills" (p. 224-225).

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Nurses have the responsibility to provide safe, non-judgmental, patient-centered care. Cherry & Jacob (2014), states “to become a competent professional in every dimension of nursing care, nurses must examine their own system of values and commit themselves to a virtuous value system” (p. 171).

Nurses have an ethical obligation to protect the public from harm. Education and information such as this can help reduce the stigma and discrimination that is attached with HIV infection and is crucial to the success of HIV prevention. Education is where the nursing profession needs to be involved. At risk populations need to understand prevention, care and treatment needs. The nursing profession must understand the benefits to this kind of treatment because this can significantly reduce HIV infection rates in the United States.

Further information regarding this medication can be found on the CDC's website and many other resources available to clinicians. Also, many scholarly articles are available discussing the research behind PrEP and HIV prevention methods. The biggest gap with this drug is providing education to the public and those at high risk of contracting HIV.

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Centers for Disease Control and Prevention. (CDC). (2016). PrEP. Retrieved from https://www.cdc.gov/hiv/basics/prep.html.

Human Rights Campaign. (n.d.). Pre-exposure prophylaxis (PrEP). Retrieved from http://www.theaidsinstitute.org/sites/default/files/attachments/HRC-PrEP_Document.pdf.

Project Inform. (2016).  PrEP pre-exposure prophylaxis: Is taking PrEP the right choice for you? Retrieved from https://www.projectinform.org/pdf/prep_msm.pdf

Treston, C., Farley, J., Harris, O., Hoyt, M. J., Kwong, J., & Van Nuys, J. (2015). PrEP Works and Is a Valuable Addition to the HIV Prevention Toolkit. JANAC: Journal Of The Association Of Nurses In AIDS Care, 26(3), 224-226. doi:10.1016/j.jana.2015.02.002.

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PrEP for HIV Prevention:  The Best Worst Kept Secret | Raphael Landovitz | TEDxUCLA

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"Preventive Medicine" has arrived for those at risk for HIV. New medical strategies are available to help prevent HIV from being transmitted. As futuristic as this concept seems, it is part of a preventive revolution for medical care - where an "ounce of prevention" may be worth more than a "pound of cure."

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PROS
• PrEP uses a single pill called Truvada, taken once daily.
• When taken as prescribed, PrEP is highly effective at blocking HIV infection.
• Has the potential to decrease STDs/STI infections due to frequency of routine blood tests.

CONS
• Frequent medical visits and routine blood tests, about every three months.
• You may have side effects from taking PrEP at first, but most people do not. Some of these side effects include: headaches, weight loss and stomach problems like nausea, diarrhea and stomach ache.
• Has potential to effect the kidney function or bones.
• Long term effects of taking PrEP studies are needed.