Degree

Doctor of Nursing Practice (DNP)

Department

Nursing

Document Type

Dissertation

Abstract

Background: HIV remains a persistent public health concern, with 1.3 million people affected worldwide. Although advances in treatment have improved long-term management, early prevention still relies on identifying individuals at elevated risk. In many primary care settings, routine HIV risk assessment is inconsistent or absent, resulting in missed opportunities to screen, educate and initiate prevention strategies such as pre-exposure prophylaxis (PrEP). This gap underscores the need for structured, evidence-based tools to improve early risk identification and strengthen HIV prevention efforts. Purpose: Implement and evaluate an evidence-based standardized screening process for HIV risk assessment to achieve early identification and enhance appropriate PrEP referrals or deployment of other risk-based interventions among patients 18 years and older, seen at a primary care clinic in southeast Louisiana over 15 weeks. Methods: A retrospective chart review was conducted following implementation of an evidence-based quality improvement initiative that incorporated a comprehensive HIV risk screening process using the Denver HIV Risk Score (DHRS) tool, a validated assessment tool. The evaluation assessed rates of HIV testing, identification of patients eligible for PrEP, PrEP recommendations for HIV-negative patients at moderate to high risk, provision of community resource information for HIV prevention and support services, and appropriate referrals or interventions for patients with positive HIV test results. Results: A total of 327 HIV risk assessments were completed, with 64 patients (19.6%) identified as moderate to high risk. Among these patients, 64 HIV tests were ordered and 60 completed, yielding 4 positive results. PrEP counseling was provided to 56 patients, community resources to 63 patients, and 4 referrals to infectious disease specialists were made. Follow-up visits were scheduled for 60 patients; 43 returned. The screening tool was used for 100% of eligible visits. Conclusion: These findings highlight the importance of implementing evidence-based comprehensive HIV risk assessment screening process in a primary care setting and have the potential to enhance identification of the HIV-at-risk population and support early linkage to care. Keywords: Human Immunodeficiency Virus, HIV, HIV risk assessment, pre-exposure prophylaxis, PrEP, primary care, Denver HIV Risk Score Tool

Date

2-6-2026

DOI

https://proquest.com/docview/3347846967

First Committee Chair

Frances Stueben

First Committee Member

Jennifer Lemoine

Second Committee Member

Jose Veras-Pola

Third Committee Member

Stephanie Arceneaux

Download

Included in

Nursing Commons

Share

COinS