Pre-exposure prophylaxis (PrEP) coverage remains low among populations most affected by HIV, and U.S. implementation outcomes for nurse-led PrEP delivery under standing orders (physician-authorized protocols permitting registered nurses to perform specified clinical actions) remain minimal. This quasi-experimental study evaluated nurse-led PrEP delivery (N = 197; April 2023-October 2024) across five South Florida sites, using a historical provider-led cohort (N = 561) for context. Female enrollment increased from 12.3% to 24.9%, and heterosexual enrollment from 16.9% to 32.5% (both p < .001). Same-day initiation occurred in 97.0% of encounters; 47.7% persisted on PrEP 6 months or longer, and 56.7% demonstrated adherence. Hispanic/Latino participants showed higher completion than non-Hispanic participants (56.2% vs. 37.0%, p = .011), whereas Black/African American participants showed lower engagement across all outcomes (p < .001) despite comparable enrollment. Findings suggest the model was associated with expanded reach into some underserved populations, alongside disparities requiring targeted engagement.
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Wendel et al. (2026) studied this question.
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