Knowledge, Culture, and Communication in HIV Prevention: A Mixed-Methods Study of Nurse Practitioners’ Roles in Pre-exposure Prophylaxis (PrEP) Uptake in Rural and Underserved Areas

HIV remains a critical global public health concern. While no cure exists, treatments like antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) effectively reduce transmission rates. However, PrEP uptake is low, especially in areas facing stigma and misinformation, such as the southern United States, where high HIV stigma further hinders compliance. This study examined PrEP-related knowledge, attitudes, and prescribing behaviors among 179 nurse practitioners (NPs) in one southeastern state. Results indicated significant gaps in PrEP knowledge. Qualitative interviews highlighted stigma rooted in religious and regional contexts and emphasized the need for better education and provider-patient communication. These findings confirm that providers with PrEP knowledge and tools to reduce stigma may foster an increase in PrEP uptake in high-need areas.