选择实施策略,以改善肯尼亚孕妇和产后人口的综合PrEP实施:一个连续的解释性混合方法分析
Sarah Hicks1, Ben Odhiambo2, Felix Abuna2
1Department of Epidemiology, University of Washington, Seattle, WA, USA. smd722@uw.edu.
将暴露前预防 (PrEP) 整合到母亲和儿童健康诊所中,面临诸如人员短缺等障碍. 优先考虑的战略重点是共同定位服务,提高怀孕期间预防艾滋病毒的诊所效率.
科学领域:
- 公共卫生 公共卫生
- 预防传染病 预防传染病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 怀孕和产后期增加了感染艾滋病毒的风险.
- 在这些时期,暴露前预防 (PrEP) 对高危人群至关重要.
- 将PrEP整合到母婴健康 (MCH) 诊所需要优化实施.
研究的目的:
- 识别和优先考虑在MCH诊所内提供PrEP的障碍和实施策略.
- 让利益相关者参与优化孕妇和产后患者的PrEP整合工作.
主要方法:
- 在肯尼亚西部采用了一种连续的解释性混合方法设计.
- 对146名医疗保健工作者进行了定量调查,并与44名政策制定者和实施者举行了利益相关者研讨会.
- 利用利克特分数和逐步淘汰来优先考虑实施战略.
主要成果:
- 关键障碍包括提供者不足,培训不足,空间有限,患者数量大.
- 主要策略集中在在MCH诊所内共同安置PrEP,快速跟踪客户,任务转移咨询和风险评估以及提供者培训.
- 利益相关方的投入完善了战略选择,考虑对工作人员和其他患者的影响.
结论:
- 人员和空间不足是整合PrEP提供的主要障碍.
- 优先考虑的战略强调服务的共同位置和提高诊所效率.
- 未来的研究将测试捆绑策略,以评估有效性和实施结果.
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