Running head: EVIDENCE-BASED PRACTICE: PROPHYLACTIC PREP MEDICATION TO PREVENT HIV AMONGST INCARCERATED

Running head: EVIDENCE-BASED PRACTICE: PROPHYLACTIC PREP MEDICATION TO PREVENT HIV AMONGST INCARCERATED MALES
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EVIDENCE-BASED PRACTICE: PROPHYLACTIC PREP MEDICATION TO PREVENT HIV AMONGST INCARCERATED MALES
Evidence-Based Practice: Prophylactic Prep Medication To Prevent HIV Amongst Incarcerated Malesno nameWestern Governors University
Impact of the Problem on the Patient
 The assessment will address the impact of HIV/AIDS among imprisoned men. Incarcerated men are at high risk of infecting each other with venereal diseases due to a lack of protection. The unprotected sex habits will lead to a high infection rate among the prisoners.
Impact of the Problem on the Organization
The institution’s high HIV/AIDS infection rate is costly, and the management may require extensive resources to care for the sick prisoners.
Identify the PICO components
            P – increased numbers of HIV infections in male prisons
            I – PrEp prophylactic medication for the prevention of HIV
            C= N0 use of prophylactic medication strategies 
            O – Decreased number of HIV infections among incarcerated males
Evidence-Based Practice Question
Among incarcerated males, does the intervention of using PrEp (pre-exposure prophylaxis medication for people at risk for HIV)  lower the number of infections in male prisons compared to not having any prophylactic strategies?
Research article:
Brinkley-Rubinstein, L., Peterson, M., Arnold, T., Nunn, A. S., Beckwith, C. G., Castonguay, B., … & Chan, P. A. (2018). Knowledge, interest, and anticipated barriers of pre-exposure prophylaxis uptake and adherence among gay, bisexual, and men who have sex with incarcerated men. PLoS One, 13(12), e0205593.
Background information
 Incarcerated gay, bisexual, and other men who have same-sex (MSM) are likely to contract HIV/AIDS in the system. Research has revealed that one in every seven HIV+ individuals spends time in jail each year.
Methodology
 Men identifying as MSM in the Rhode Island Department of Corrections (RIDOC) were approached to participate in the exercise. Only one possible participant declined, while the rest gave verbal consent for confidentiality. The participant had to be over eight years, self-reported as having HIV- and could read and write in English. Semi-structured interviews were conducted and lasted about three-quarters of an hour. Qualitative research methods trained assistants administered the interviews. Each participant received $30 compensation.
Level of Evidence: Level I as per the John Hopkins Nursing EBP model
Data Analysis: analyzed on three themes: knowledge and interest in PreEP, need for service provision, and perceived barrier.
Ethical Considerations: written consent was banished for the confidentiality and privacy of the participants.
Quality Rating: High. The study was professionally carried out, and it protected the participants.
Analysis of the Results / Conclusions: the study is among pioneer research on criminal justice affiliated MSM. PreEp knowledge was low, but individuals had the will to learn. The challenges identified were community re-entry, access to transport, and the cost and stigma of using PreEP.
Non-Research Article Title: Riddell, J., Amico, K. R., & Mayer, K. H. (2018). HIV preexposure prophylaxis: a review. Jama, 319(12), 1261-1268.
Background Introduction
 HIV treatment has progressed over the years, but infections are still high. Research indicates that 1 in every eight people is unaware of their HIV status.
Type of Evidence
Statistical research through literature review.
Level of Evidence
Level 1evidence as per the John Hopkins Nursing EBP model
Quality Rating- High- the researchers used scholarly and peer-reviewed articles.
Author’s Recommendations-
 Primary care healthcare professionals continually record their patients’ sexual and drug abuse history. PreEp information should be availed to MSM who do not often use protection during sexual intercourse. Patients should be advised against sharing drug needles for injection, and they should learn that regular use of PreEp reduces infection rates, but the medicine does not prevent other STIs. A condom must be used for the prevention of other STIs.
Recommended Practice Change
Clinicians should have a solid background about patients for proper diagnosis and advice on PreEp.
Key Stakeholders
MSM, health care workers, and patients
Barrier to Implementation
 Cost and stigma
Strategy to Overcome the Implementation Barrier
Training and education from health professionals
Indicators to Measure the Outcome
Reduced infection rate and high acceptance of the PreEP programs by MSM.
References
Brinkley-Rubinstein, L., Peterson, M., Arnold, T., Nunn, A. S., Beckwith, C. G., Castonguay, B., … & Chan, P. A. (2018). Knowledge, interest, and anticipated barriers of pre-exposure prophylaxis uptake and adherence among gay, bisexual, and men who have sex with men who are incarcerated. PLoS One, 13(12), e0205593.
Riddell, J., Amico, K. R., & Mayer, K. H. (2018). HIV preexposure prophylaxis: a review. Jama, 319(12), 1261-1268.