Knowledge, attitudes and practices of primary care nurses regarding human immunodeficiency virus pre-exposure prophylaxis in Mhlontlo sub-district municipality, Eastern Cape, South Africa

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BACKGROUND: Pre-exposure prophylaxis (PrEP) is key for preventing human immunodeficiency virus (HIV) transmission, but uptake is limited, especially in rural areas of South Africa. Nurses in primary healthcare (PHC) play a vital role in delivering PrEP, yet little is known about their knowledge, attitudes and practices (KAP) in this area. METHODS: A cross-sectional analytic study was conducted among 178 nurses from three healthcare facilities in the Mhlontlo sub-district of the OR Tambo District, Eastern Cape. A structured, self-administered questionnaire was used to assess demographic variables, PrEP-related knowledge, attitudes and practices. RESULTS: While 78.7% of participants were aware of PrEP, only 43.3% demonstrated comprehensive knowledge, and just 46.6% had ever initiated a client on PrEP. Community health centre (CHC) nurses demonstrated significantly better knowledge and practice than those in district hospitals (p 0.001). Attitudes were generally positive, with 91.4% agreeing that PrEP is an effective HIV prevention method. However, 73.1% believed it could lead to increased transmission of sexually transmitted infections (STIs). The study identified barriers to PrEP implementation, including lack of training (57.9%), protocol shortages (25.3%) and insufficient time (40.4%). CONCLUSION: Primary care nurses demonstrate a high level of awareness and positive attitudes towards PrEP; however, knowledge and practice gaps persist. Primary care providers' capacity building through targeted training, integration and improved human and healthcare resources is vital to enhancing PrEP implementation for national HIV prevention.Contribution: This study highlighted the frontline primary care providers' vital roles in the PrEP for prevention of HIV infection in resource-limited rural healthcare settings.

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