检查艾滋病毒暴露前预防的需要,可用性和潜在的药房整合在美国东南部
Kristin R V Harrington1,2, Christina Chandra1, Daniel I Alohan3
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
JAMA network open
|July 27, 2023
概括
将艾滋病毒预防服务扩展到药房,可以显著增加美国东南部高风险人群的暴露前预防 (PrEP) 接入. 这一战略对于通过改善PrEP吸收来结束艾滋病毒流行至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 每日暴露前预防 (PrEP) 在预防艾滋病毒感染方面非常有效,但吸收率仍然很低,特别是在美国东南部,因为处方地点的访问有限.
- 药房提供一种潜在的解决方案,以提高PrEP可访问性,但它们在补充现有服务方面的作用需要进一步研究.
研究的目的:
- 分析美国东南部高优先级艾滋病毒预防地区的PrEP处方地点和药房的地理分布.
- 根据艾滋病毒风险,比较PrEP处方地点与药房的设施与需求比率 (PFNR).
- 评估药房扩大PrEP获取的潜力.
主要方法:
- 一项采用2021年数据的横截面研究,重点关注美国东南部高优先级的结束艾滋病毒流行 (EHE) 司法管辖区.
- 将PrEP处方地点和药房数据叠加到每10万人的5年HIV风险地图上.
- 计算和比较PFNR以评估与艾滋病毒风险相关的服务的地理可用性.
主要成果:
- 处方地点分布不均,高艾滋病毒风险地区的设施较少,而药房分布更均.
- 药房的PFNR显著高 (平均值为0.7),而不是PREP处方地点 (平均值为0.008),这表明潜在的覆盖范围更大.
- 肯塔基州,南卡罗来纳州和田纳西州显示,通过药房扩张增加PrEP获取的最大潜力.
结论:
- 将包括PrEP在内的艾滋病毒预防服务扩展到美国东南部的药房,可以大大提高接触风险人群的能力.
- 建议立法改变,允许药剂师处方PrEP并提供艾滋病毒预防服务,这是结束艾滋病毒流行病的关键一步.
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