{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:46:41Z","timestamp":1788929201221,"version":"build-2803163510"},"reference-count":28,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000085","name":"Ontario HIV Treatment Network","doi-asserted-by":"publisher","award":["1089"],"award-info":[{"award-number":["1089"]}],"id":[{"id":"10.13039\/501100000085","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,12,11]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To report the results of a nurse-led pre-exposure prophylaxis (PrEP) delivery service.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This was a prospective cohort study conducted from 5 August 2018 to 4 March 2020. It involved manual chart review to collect data. Variables were described using frequencies and percentages and analysed using \u03c7<jats:sup>2<\/jats:sup> testing. Those significant in bivariate analysis were retained and entered into a binary multiple logistic regression. Hierarchical modelling was used, and only significant factors were retained.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>This study occurred in an urban public health unit and community-based sexually transmitted infection (STI) clinic in Ottawa, Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Of all persons who were diagnosed with a bacterial STI in Ottawa and everyone who presented to our STI clinic during the study period, there were 347 patients who met our high-risk criteria for PrEP; these criteria included patients who newly presented with any of the following: HIV contacts, diagnosed with a bacterial STI or single use of HIV PEP. Further, eligibility could be determined based on clinical judgement. Patients who met the foregoing criteria were appropriate for PrEP-RN, while lower-risk patients were referred to elsewhere. Of the 347 patients who met our high-risk criteria, 47% accepted and 53% declined. Of those who accepted, 80% selected PrEP-registered nurse (RN).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>Uptake, acceptance, engagement and attrition factors of participants who obtained PrEP through PrEP-RN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>69% of participants who were eligible attended their intake PrEP-RN visit. 66% were retained in care. Half of participants continued PrEP and half were lost to follow-up. We found no significant differences in the uptake, acceptance, engagement and attrition factors of participants who accessed PrEP-RN regarding reason for referral, age, ethnicity, sexual orientation, annual income, education attainted, insurance status, if they have a primary care provider, presence or absence of depression or anxiety and evidence of newly acquired STI during the study period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Nurse-led PrEP is an appropriate strategy for PrEP delivery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-040817","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T13:40:21Z","timestamp":1610026821000},"page":"e040817","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Nurse-led PrEP-RN clinic: a prospective cohort study exploring task-Shifting HIV prevention to public health nurses"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-1409","authenticated-orcid":false,"given":"Patrick","family":"O'Byrne","sequence":"first","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Vandyk","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Orser","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Haines","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"key":"2025101815130662000_11.1.e040817.1","first-page":"E1448","article-title":"Canadian guideline on HIV preexposure prophylaxis and nonoccupational postexposure prophylaxis","volume":"187","author":"DHS","year":"2017","journal-title":"CMAJ"},{"key":"2025101815130662000_11.1.e040817.2","unstructured":"World Health Organization . Task shifting: global recommendations and guidelines, 2008. Available: https:\/\/www.who.int\/healthsystems\/TTR-TaskShifting.pdf?ua=1"},{"key":"2025101815130662000_11.1.e040817.3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0105283"},{"key":"2025101815130662000_11.1.e040817.4","first-page":"1","article-title":"Implementing a nurse-led HIV pre-exposure prophylaxis service (PrEP-RN) in a public health unit STI clinic","volume":"7","author":"Orser","year":"2019","journal-title":"HRO"},{"key":"2025101815130662000_11.1.e040817.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-06001-y"},{"key":"2025101815130662000_11.1.e040817.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-018-3324-2","article-title":"Decentralizing the delivery of HIV pre-exposure prophylaxis (PrEP) through family physicians and sexual health clinic nurses: a dissemination and implementation study protocol","volume":"18","author":"Sharma","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"2025101815130662000_11.1.e040817.7","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/JNC.0000000000000075","article-title":"PrEP-RN: clinical considerations and protocols for nurse-led PrEP","volume":"30","author":"O\u02bcByrne","year":"2019","journal-title":"J Assoc Nurses AIDS Care"},{"key":"2025101815130662000_11.1.e040817.8","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1071\/SH18055","article-title":"Evolution of a pre-exposure prophylaxis (PrEP) service in a community-located sexual health clinic: Concise report of the PrEPxpress","volume":"15","author":"Girometti","year":"2018","journal-title":"Sex Health"},{"key":"2025101815130662000_11.1.e040817.9","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1071\/SH18076","article-title":"Nurse-Led pre-exposure prophylaxis: a non-traditional model to provide HIV prevention in a resource-constrained, pragmatic clinical trial","volume":"15","author":"Schmidt","year":"2018","journal-title":"Sex Health"},{"key":"2025101815130662000_11.1.e040817.10","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1606-4"},{"key":"2025101815130662000_11.1.e040817.11","first-page":"5","article-title":"Responding to critiques of the Canadian PreP guidelines: increasing equitable access through a nurse-led active-offer PrEP service (PrEP-RN)","volume":"28","author":"O\u2019Byrne","year":"2019","journal-title":"Can J Hum Sex"},{"key":"2025101815130662000_11.1.e040817.12","doi-asserted-by":"crossref","unstructured":"O\u2019Byrne P , Hollett M , Campbell B . A nurse practitioner leadership model for a sexual health clinic in Canada: staff feedback about implementation and operations. Nurse Leader 2020.","DOI":"10.1016\/j.mnl.2019.11.016"},{"key":"2025101815130662000_11.1.e040817.13","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170494"},{"key":"2025101815130662000_11.1.e040817.14","first-page":"232595822093976","article-title":"Immediate PreP after PEP: results from an observational nurse-led PEP2PrEP study","volume":"19","author":"O'Byrne","year":"2020","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"2025101815130662000_11.1.e040817.15","unstructured":"World Health Organization (WHO) . Timeline: WHO\u2019s COVID-19 Response. Available: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/interactive-timeline#! 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The costs of HIV pre-exposure prophylaxis (PreP) care delivery: comparing specialists, primary care, and PrEP-RN. 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(PrEP-RN) referrals: analysis of uptake rates and reasons for declining. AIDS & Behaviour 2019:1\u20139.","DOI":"10.1007\/s10461-019-02745-9"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-040817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T22:13:14Z","timestamp":1760825594000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-040817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,7]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/bmjopen-2020-040817"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-040817","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}