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HIV PrEP in Primary Care
Rewards and Challenges of PrEP Delivery in Primary Care

Released: May 30, 2025

Expiration: May 29, 2026

Tamara White
Tamara White, DNP, FNP-C
Activity Information

Activity

Progress
1
Course Completed
Key Takeaways
  • Managing ongoing PrEP administration in my primary care setting has been seamless from a clinical perspective. However, financial and administrative barriers can delay care.
  • A proactive approach of initiating insurance checks early, coordinating closely with specialty pharmacies, and educating patients about what to expect has been key to addressing these challenges.

As a family nurse practitioner, I have always believed that primary care is not just about treating illness but about empowering patients with tools to live healthier, longer lives. That is exactly what led me to start offering HIV pre-exposure prophylaxis (PrEP) in my practice. The opportunity to have a proactive role in HIV prevention felt not only aligned with my values as a healthcare professional, but also essential in my mission to address health disparities and deliver inclusive, patient-centered care.

Prescribing PrEP has become one of the most meaningful aspects of my clinical work. It gives me the chance to offer my patients—many of whom are members of communities disproportionately affected by HIV—a powerful tool to protect their health. Whether it is through daily oral medication or the newer injectable formulations, I am able to counsel patients on safe sex practices and provide them with evidence-based prevention options.

From a clinical standpoint, integrating PrEP into practice has been refreshingly straightforward. The CDC guidelines offer a clear roadmap for assessment, initiation, and monitoring. In addition, I am fortunate to work alongside a dedicated HIV PrEP and prevention nurse in our clinic. This partnership has streamlined workflows and ensures that our patients receive comprehensive, coordinated care, which is a critical component for supporting adherence and long-term success with PrEP.

Getting Ahead of Challenges
Of course, no implementation is without challenges. Although managing ongoing PrEP administration has been seamless from a clinical perspective, initiating injectable PrEP has presented a unique set of hurdles, most notably, insurance authorization and cost navigation. What I have learned is that these financial and administrative barriers can delay care, sometimes at the expense of a patient’s trust or enthusiasm. As a result, we have adopted a proactive approach that includes initiating insurance checks early, closely coordinating with specialty pharmacies, and educating patients about what to expect. These steps, although time-consuming, have become essential parts of our PrEP initiation process.

This experience has underscored the important lesson that clinical efficacy is only part of the equation. Accessibility matters just as much. It is not enough to have PrEP available. It must be accessible, affordable, and delivered in a way that feels respectful and affirming to the patient. By anticipating barriers and partnering closely with our clinical team, we have been able to reduce friction points and keep the focus on where it belongs—prevention and empowerment.

In many ways, offering PrEP has expanded the scope of my practice. It has deepened my relationships with patients, especially those who may have previously felt unseen or stigmatized in healthcare settings. Moreover, it has reinforced the power of partnerships, which is important in advancing public health outcomes.

I am proud to be part of a workforce that is actively working to prevent HIV transmission. By continuing to expand access to PrEP, support workforce education, and center the voices of both healthcare professionals and patients, we can shift the trajectory of the HIV epidemic. For me, prescribing PrEP is not just a clinical decision; it is a commitment to equity, prevention, and progress.

Your Thoughts?
Which aspects of PrEP delivery have been the most challenging and the most rewarding? What barriers are preventing you from delivering PrEP? Share your thoughts by posting a comment.