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Final sample (<jats:italic>N<\/jats:italic>\u00a0=\u00a0369) was predominantly White, non\u2010Hispanic, female advanced practice nurses in urban practices (mean age\u00a0=\u00a046). Conceptual model for structural equation model included 29 original\/composite variables and five latent factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Final model consisted of 11 variables and four factors: agency, community, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention practices (including screening) and motivation to adopt evidence\u2010based practices overall. Community had direct effects on <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention practices (estimate\u00a0=\u00a00.28) and agency (estimate\u00a0=\u00a00.29). Agency had direct effects on <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention practices (estimate\u00a0=\u00a00.74) and motivation to adopt evidence\u2010based practices (estimate\u00a0=\u00a00.24). Community had indirect effects, through agency, on the two remaining factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Barriers exist against pre\u2010exposure prophylaxis implementation, although practice guidelines are available. <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention practices must be integrated across organizational structures, especially in high\u2010risk communities, whereas practice change is more effective when focused on changing providers\u2019 attitudes towards intervention. When planning a pre\u2010exposure prophylaxis intervention, advancing inputs from healthcare professionals, organizational leadership and community members, is crucial to success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Impact<\/jats:title><jats:p>In settings where advanced practice nurses are primary contact points for health care, they may be best positioned to have an impact on implementation of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> risk reduction strategies. Further research is needed to optimize their contributions to pre\u2010exposure prophylaxis implementation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jan.14019","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T04:41:27Z","timestamp":1554525687000},"page":"2559-2569","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["<scp>HIV<\/scp> pre\u2010exposure prophylaxis uptake by advanced practice nurses: Interplay of agency, community and attitudinal factors"],"prefix":"10.1111","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8798-0894","authenticated-orcid":false,"given":"Wasantha","family":"Jayawardene","sequence":"first","affiliation":[{"name":"Institute for Research on Addictive Behavior Indiana University School of Public Health\u2010Bloomington Bloomington Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Carter","sequence":"additional","affiliation":[{"name":"School of Nursing Indiana University Bloomington Bloomington Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Agley","sequence":"additional","affiliation":[{"name":"Institute for Research on Addictive Behavior Indiana University School of Public Health\u2010Bloomington Bloomington Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Meyerson","sequence":"additional","affiliation":[{"name":"Applied Health Science Indiana University School of Public Health\u2010Bloomington Indiana University Bloomington Bloomington Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin R.","family":"Garcia","sequence":"additional","affiliation":[{"name":"The Kinsey Institute and Department of Gender Studies Indiana University Bloomington Indiana University Bloomington Bloomington Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Miller","sequence":"additional","affiliation":[{"name":"School of Nursing Indianapolis Indiana University - Purdue University Indianapolis Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0019188"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2016.09.007"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001182"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2006.09.018"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000535"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61022-8"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/15381501.2010.525480"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.14.2.172.23902"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2009.01336.x"},{"key":"e_1_2_10_11_1","unstructured":"Centers for Disease Control and Prevention. 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