应用三级方法来解决乌干达口服预暴露预防剂摄入量和连续性的差距:一种混合方法方法
Simon Sensalire1, Abel Nkolo2, Juliana Nabwire Ssali3
1U.S. Agency for International Development Uganda Health Activity, Kampala, Uganda. ssensalire@urc-chs.com.
Global health, science and practice
|March 11, 2024
概括
一个三级的方法显著改善了乌干达的暴露前预防 (PrEP) 吸收和连续性,通过解决诸如恐惧,耻辱和访问等障碍. 这种方法增强了艾滋病毒预防计划.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 实施科学 实施科学
背景情况:
- 口服暴露前预防 (PrEP) 的低吸收率和连续性仍然是乌干达艾滋病毒预防工作的重大挑战.
- 了解PREP启动和遵守的具体障碍对于有效实施计划至关重要.
研究的目的:
- 描述一种新的三级方法,以识别和解决乌干达口服PrEP吸收和连续性的障碍.
- 评估这种方法在改善PrEP注册和保留方面的有效性.
主要方法:
- 混合方法设计,包括差距分析,根本原因分析 (RCA) 和质量改进协作.
- 关于PrEP级联指标的回顾性,横截面和前性数据收集.
- 在RCA中,有1334名客户拒绝了PrEP和1266人错过了预约;协作测试的干预措施映射到已识别的障碍.
主要成果:
- 最初的PrEP注册人数仅占符合条件的人口的60%,季度补充人数低于30%.
- 关键的障碍包括对副作用的恐惧,药物危害感知,遵守问题,耻辱感,获取问题和药物负担.
- 协作式PrEP干预导致统计学上显著增加了入学率 (64%至89%) 和连续性 (51%至78%).
结论:
- 三层方法有效地加强了PrEP编程,通过系统地解决客户级的障碍.
- 该模型提供了一个可扩展的策略,用于在类似的实施环境中改善艾滋病毒预防结果.
- 质量改善合作伙伴对于优化临床服务提供和PrEP级联性能至关重要.
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