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

## TL;DR

This study examines how well primary care nurses in rural South Africa understand and use HIV prevention methods like PrEP.

## Contribution

The study provides insights into nurses' knowledge, attitudes, and practices regarding PrEP in a rural South African setting.

## Key findings

- Most nurses were aware of PrEP, but only about 43% had comprehensive knowledge.
- CHC nurses had better knowledge and practice than those in district hospitals.
- Barriers to PrEP implementation included lack of training and insufficient time.

## Abstract

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.

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.

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%).

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.

This study highlighted the frontline primary care providers’ vital roles in the PrEP for prevention of HIV infection in resource-limited rural healthcare settings.