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Difficulty: MediumHigh Risk Behaviors

A community health nurse is conducting a follow-up assessment on a 24-year-old client who was prescribed pre-exposure prophylaxis (PrEP) for HIV prevention 3 months ago. The client states, "I take my medication every single day as prescribed, so I have stopped using condoms during sexual encounters." Which of the following is the most appropriate response by the nurse?

  1. A
    Since PrEP serves as primary prevention, you only need to use condoms as secondary prevention if your partner is symptomatic.
  2. Pre-exposure prophylaxis significantly reduces your risk for HIV, but it offers no protection against other sexually transmitted infections.Answer
  3. C
    Why did you decide to stop using condoms without discussing it with a healthcare provider first?
  4. D
    I will need to report your unprotected sexual activity to the public health department for partner tracing.

Answer

The most appropriate response is to inform the client that while PrEP significantly reduces the risk of HIV, it offers no protection against other sexually transmitted infections.
The correct answer directly addresses the client's knowledge deficit using a factual, non-judgmental approach. Pre-exposure prophylaxis (PrEP) is highly effective at preventing the transmission of HIV, but it does not provide a barrier against other sexually transmitted infections (STIs). Therefore, the nurse must provide accurate harm-reduction education by emphasizing that barrier methods are still necessary.

Step-by-Step Solution

1
Analyze the client's statement.
The client mistakenly believes that taking PrEP eliminates the need for condom use during sexual encounters.
Identifying the specific knowledge deficit is the first step in providing targeted harm-reduction education.
2
Evaluate the clinical facts regarding PrEP.
PrEP is highly effective at preventing HIV infection but provides no physical barrier against bacterial or viral sexually transmitted infections (STIs) such as syphilis, gonorrhea, or chlamydia.
Understanding the pharmacological and physical limitations of the treatment forms the basis for the necessary nursing intervention.
3
Select the most therapeutic and accurate response.
The nurse must provide factual, non-judgmental education that directly corrects the client's misconception.
Direct, factual education promotes harm reduction and client safety while maintaining a trusting therapeutic relationship.

Key Concept

Harm Reduction and PrEP Education
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Topics

High Risk Behaviors

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