双重预防避孕药和艾滋病毒暴露前预防的成本效益
Masabho P Milali1, Danielle Resar2, David Kaftan1
1Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States.
Frontiers in reproductive health
|June 2, 2023
概括
双重预防药丸 (DPP) 显示了在撒哈拉以南非洲需要艾滋病毒预防 (PrEP) 和避孕的妇女的潜在成本效益. 然而,坚持是实现好处和避免伤害的关键.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 卫生经济学 卫生经济学
背景情况:
- 撒哈拉以南非洲地区面临着高艾滋病毒感染率和意外怀孕.
- 双重预防药丸 (DPP) 结合了艾滋病毒暴露前预防 (PrEP) 和口服避孕药.
- 医疗保健资源限制需要对新干预措施进行成本效益评估.
研究的目的:
- 评估在撒哈拉以南非洲地区的DPP的成本效益.
- 确定DPP的最佳用户群和使用案例.
- 评估DPP对艾滋病毒感染和意外怀孕的影响.
主要方法:
- 一个基于代理的HIV模型被增强了孕产妇的健康和怀孕参数.
- 模拟考虑了各种用户群体 (15-49岁,性工作者,血清不一致的夫妇) 和坚持水平.
- 在肯尼亚,津巴布韦和南非,分析了30年的成本效益水平.
主要成果:
- 对于那些需要避孕和口服PrEP的人来说,DPP具有成本效益.
- 对于不使用PrEP的性工作者和血清异调夫妇来说,DPP是节省成本的.
- 如果它减少了口服避孕药的坚持,DPP可能是有害的;对于一般口服避孕药的使用者来说,它不具有成本效益.
结论:
- 在高风险人群中,DPP可以具有成本效益和节省成本.
- 用户坚持是DPP成功的关键;辅导是必不可少的.
- 需要进一步研究现实世界的坚持和避孕药益处的保存.
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