Shifting PrEP Initiation from Practitioner to Nurse: a clinic-level multi-modal intervention protocol to increase PrEP uptake among women at increased risk of HIV acquisition in a U.S. OB/GYN clinical setting

Women comprise 20% of new HIV diagnoses in the U.S. with 86% attributed to heterosexual contact, but HIV pre-exposure prophylaxis (PrEP) uptake is low. OB/GYN clinics are ideal settings to increase HIV prevention counseling for cisgender women, as patients are more likely to discuss their sexual behavior, undergo sexually transmitted infection screening, and receive risk reduction counseling. Our study will assess the feasibility, acceptability, and effectiveness of a registered nurse (RN)-led PrEP project in OB/GYN clinics. Microlearning and Plan-Do-Study-Act cycles will be performed, followed by a randomized controlled trial (RCT). A total of cisgender women determined to be at-risk for HIV will be randomized to standard of care with electronic medical record enhancements (e-SOC) or e-SOC with contact and PrEP counselling by an RN, who will be able to prescribe PrEP under protocol guidance. By shifting HIV PrEP counselling to a nurse, clinics may be able to increase PrEP awareness and uptake. Registered with clinicaltrials.gov: NCT05095818