Advanced Practice Nurses' Knowledge of Sexually Transmitted Infection and Established Counseling Guidelines

Abstract

Background: Sexually transmitted infection (STI) rates represent a significant health disparity among young adult African American women. A major factor contributing to this issue is inconsistent condom use. This is especially a challenge for the state of Georgia, which has a high incidence of STI among the southern states. STI prevention counseling delivery through primary care providers is the primary recommendation from the Centers for Disease Control and Prevention and U.S. Preventive Services Taskforce. However, knowledge, attitudes, and practices of STI prevention counseling by advanced practice registered nurses (APRN) who care for young adult African American women are unknown in Georgia.Purpose: This doctor of nursing practice project investigated knowledge, attitudes, and practices of STI prevention by Georgia APRNs caring for young adult African American women on an outpatient basis and determined congruency of their counseling with primary prevention guide-lines. Methods: The design was descriptive cross-sectional. An online survey using Qualtrics software was distributed via professional listservs and postal mail to eligible Georgia APRNs currently in practice. Participants' knowledge of STI, STI prevention, and current practice guidelines and recommendations were assessed using knowledge questionnaires including true/false and multiple choice questions. Participants' attitudes regarding STI prevention counseling with young African American women and current APRN behaviors, in relation to current practice guidelines, were measured using Likert-type scales. Outcomes: The final sample size included 22 participants. Forty initiated the survey, ten did not meet eligibility criteria, six ended the survey during eligibility screening, and two ended the survey after completing less than seven percent of it. In general, participants were knowledgeable of STI and the majority of participants were knowledgeable of the CDC and USPSTF guidelines. The majority of participants felt comfortable discussing sexual practices with patients and providing feedback and advice on reducing STI risk behavior. However, the majority of participants did not believe that their current practice setting actively supported their delivery of STI prevention counseling. Overall, participants' practices were more congruent with the CDC guidelines compared to the USPSTF guidelines. This was reflected in knowledge and practice behaviors, specifically assessing for STI, providing feedback on risk behavior, and advising on behavior change with STI-infected patients and those at risk for STI. Fewer chose the USPSTF as their established practice guideline. This was revealed in practice behaviors pertaining to 'high-risk' counseling, as few tended to set goals for STI risk behavior change, document behavior goals, refer to STI resources, or follow up with referrals made to other STI risk reduction programs. Practice implications: Although overall APRN knowledge of STI was high, there were some knowledge deficits relating to appropriate barrier methods for viral-based STI and high-risk sexual behaviors associated with HBV. There was also a lack of knowledge and practice behaviors of the USPSTF STI prevention counseling guidelines. Therefore, future studies and interventions should aim to educate APRNs about these knowledge and practice insufficiencies.