Executive summary: Pre-exposure prophylaxis for prevention of HIV infection in adults in Spain: July 2016

Knowledge, Attitudes, and Intentions towards HIV Pre-Exposure Prophylaxis among Nursing Students in Spain

“…The level of knowledge of PrEP (drugs used, route and schedule of administration, contraindications, requirements prior to the initiation of PrEP, follow-up required and efficacy (questions 11–18)) has been lower than that registered in previous studies carried out among students of other healthcare degrees [ 24 ] or healthcare professionals [ 19 , 25 , 26 , 27 , 28 ]. These findings corroborate the lack of approach of this topic in the current curriculum of the nursing degree (83.24 % had never heard of PrEP and less than 50% said that they had received information about it during the training programme in the nursing degree), in spite of scientific evidence supports its usefulness in population groups at high risk for HIV infection, such as MSM [ 6 , 7 , 29 ], heterosexual women and men [ 8 ] and injection drug users [ 9 ], as long as there exists a good therapeutic adherence [ 5 , 14 ]. The absence of this topic in the current curriculum of the nursing degree could be related to the recent implementation of PrEP [ 30 ], after the last renewal of accreditation of the nursing degree of the University of Santiago de Compostela (academic course 2015–2016).…”

“…Nevertheless, the current evidence suggests that the chance of drug resistance is very low, except when PrEP is started during unrecognized, seronegative acute HIV infection [ 34 , 35 ]. This is the reason why it is necessary to have an HIV test before starting PrEP and do a follow-up every three months to monitor for seroconversion [ 5 , 18 ]. Likewise, one-quarter of participants thought that the use of PrEP could be associated with an increase of sexual risk behaviours (question 21) as well as a weakening of the attention of the National Health System towards other important prevention strategies (question 23).…”

“…In Spain, with a rate of new HIV diagnoses higher than the average in European Union (EU)/European Economic Area (EEA) [ 2 ], a total of 3244 new cases of HIV infection were recorded in 2019, the majority in young men (85.3%, average median age of 36), mainly in men who have sex with men (MSM; 56.4%) [ 3 ]. These figures reveal transmission through unprotected sex as the main route of virus spread, and they demonstrate the need for more preventive strategies in combination with classic interventions (such as condom use), which are clearly insufficient [ 4 , 5 ].…”

“…The efficacy of daily PrEP based on regimens with tenofovir disoproxil fumarate alone [ 8 ] or in combination with emtricitabine (Truvada ® ) [ 6 , 13 ] is strongly dependent on the adherence [ 5 , 14 ]. According to the literature, some of the barriers that could hamper the adherence are: mental health problems, mobility, stigma, risk misperception, the need to conceal PrEP use, social factors (e.g., unstable housing), substance use, cost or the potential side effects [ 15 , 16 , 17 ].…”

“…According to the literature, some of the barriers that could hamper the adherence are: mental health problems, mobility, stigma, risk misperception, the need to conceal PrEP use, social factors (e.g., unstable housing), substance use, cost or the potential side effects [ 15 , 16 , 17 ]. Although PrEP has not been associated with severe side effects (e.g., gastrointestinal symptoms, nausea, headache, loss of appetite or tiredness), while taking PrEP, a regular clinical and analytical follow-up every 3 months is required in order to evaluate tolerance, toxicity, adherence, HIV infection and other STDs [ 5 , 18 ].…”