Preventing HIV through preexposure prophylaxis: An evaluation of primary care nurse practitioner programs in the United States

BACKGROUND: Preexposure prophylaxis (PrEP) is a highly effective strategy for preventing HIV transmission and a key component of national HIV prevention efforts. Because nurse practitioners (NPs) deliver a substantial proportion of primary care in the United States, graduate NP education plays a critical role in preparing the workforce to implement PrEP. National data describing how PrEP education is incorporated into family nurse practitioner (FNP) and adult-gerontology primary care nurse practitioner (AGPCNP) programs remain limited. PURPOSE: To examine the scope, delivery, and evaluation of PrEP education in US FNP and AGPCNP programs and to assess program directors' confidence in graduate preparedness for PrEP implementation. METHODOLOGY: A national web-based survey was completed by 36 FNP and AGPCNP program directors; survey domains included PrEP curricular inclusion and instructional time, instructional modalities and course placement, methods used to assess learner competency, directors' confidence in graduate preparedness, timelines for PrEP integration, and associations with program characteristics. RESULTS: Most programs reported including PrEP content; however, instruction was typically brief and primarily didactic. Experiential learning methods, such as simulation or case-based activities, were infrequently used, and formal assessment of PrEP-specific competency was inconsistent. Program directors reported moderate confidence in graduates' preparedness to manage HIV prevention, and program type was not associated with confidence in PrEP preparedness. CONCLUSIONS: Preexposure prophylaxis education is included in graduate primary care NP curricula, but instructional depth and assessment approaches vary. IMPLICATIONS: Greater emphasis on competency-based instruction, experiential learning, and systematic assessment may improve NP graduates' readiness to deliver HIV prevention in primary care settings.