PrEP use in Australia as part of and individual and population HIV risk reduction strategy is now wide-spread. Nurses have an important role to play (Table 15).
Access to PrEP is crucial to realising its benefits. Nurses should be aware of those not currently benefiting from PrEP (younger men and those born overseas and without access to Medicare) and asses their barriers to and options for access.
Adherence to the PrEP dosing schedule is also crucial to realising its benfits. Those who most need PrEP may well be those who most struggle to maintain these high levels of adherence. They will be men who have sex with men (or others) with significant alcohol or other drug issues or significant mental health problems. Rather than exclude these vulnerable groups from PrEP access, because of fears about poor engagement and adherence, ways should be found to support the adherence required. In the IDU Bangkok PrEP study, participants received Truvada by directly observed therapy (DOT) 86% (SD 25%) of the time and were compensated for travel and the time required by the study procedures.
Nurses can and ought to have a pivotal role in exploring and providing innovative methods of PrEP medication adherence support in marginalised, vulnerable populations which could include DOT, other forms of highly supported therapy and the provision of financial incentives.
Table 15: The nurse’s role in pre-exposure prophylaxis (PrEP)