差异化直接到药房的PrEP补充访问的效果与客户的艾滋病毒自我测试对诊所访问时间和早期PrEP延续的影响
Kidist Belay Zewdie1,2, Kenneth Ngure2,3, Margaret Mwangi4
1Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Journal of the International AIDS Society
|March 6, 2024
概括
直接去药房进行口服暴露前预防 (PrEP) 减少了35%的临床时间,并改善了艾滋病毒预防的延续. 这种以客户为中心的方法提高了公共卫生机构在公共卫生环境中提供PrEP的效果.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 制药科学 制药科学
背景情况:
- 临床层面的障碍,例如长时间的访问时间,可能会阻碍客户继续服用口服暴露前预防药物 (PrEP).
- 在非洲扩大PrEP的提供需要解决这些障碍,以确保持续使用.
- 优化服务提供模式对于有效的艾滋病毒预防计划至关重要.
研究的目的:
- 评估差异化直接到药房的PrEP补充干预对诊所访问时间和PrEP延续的影响.
- 评估客户自检艾滋病毒 (HIVST) 和客户导航器在PrEP补充过程中整合的有效性.
- 确定该干预措施是否改善了接受PrEP的个体在护理中的坚持和保留.
主要方法:
- 在肯尼亚的四个公共卫生艾滋病毒诊所进行了一项准实验性评估,持续了两年.
- 两个诊所实施了直接到药房的干预方案,包括HIVST和药剂师主导的分发.
- 同时的对照诊所遵循了通常的诊所流程;测量结果包括访问持续时间,PrEP延续率和tenofovir-diphosphate (TFV-DP) 水平.
主要成果:
- 这项干预措施显著减少了总诊所访问时间的35% (中位数为33分钟而不是51分钟;p<0.001).
- 与对照诊所相比,在干预诊所的PrEP延续率在1,3个月和6个月后更高.
- 在干血斑点中检测到二酸盐 (TFV-DP) 的高 (85%) 和在不同组之间相似,表明良好的坚持.
结论:
- 一个以客户为中心的PrEP交付模式,结合直接到药房的补充和HIVST,有效地减少了诊所访问时间.
- 这种优化的方法显著提高了公共卫生艾滋病毒诊所的PrEP延续率.
- 这些发现支持差异化服务提供的可扩展性,以加强艾滋病毒预防工作.
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