升级PrEP:在系统和结构层面实施战略,以扩大PrEP在美国的使用
Sarah E Rutstein1, Kathryn E Muessig2
1Division of Infectious Diseases, Department of Medicine, University of North Carolina, 130 Mason Farm Road, Chapel Hill, NC, 27599, USA. srutstein@unc.edu.
系统层面的策略,如任务转移和远程医疗,可以改善美国艾滋病毒预防的暴露前预防 (PrEP) 吸收. 量身定制的护理导航显示出希望,但需要对长期影响进行更多研究.
科学领域:
- 实施科学 实施科学
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
背景情况:
- 暴露前预防药物 (PrEP) 摄入量不足,阻碍了结束美国艾滋病毒流行病的努力.
- 实施科学对于将有效的PrEP策略从临床试验转化为现实环境至关重要.
研究的目的:
- 审查系统层面和结构战略,以解决在分散的美国医疗保健系统中使用PrEP的障碍.
- 探索提高PrEP吸收的潜在影响和机会.
主要方法:
- 实施科学战略的审查,以系统和结构层面为目标.
- 分析任务转移,服务整合,扩展远程医疗和护理导航.
主要成果:
- 任务转移和远程医疗为增加PrEP访问提供了潜力,但证据有限,障碍仍然存在.
- 整合PrEP服务可以集中资源,但对工作人员有未经审查的影响.
- 量身定制的护理导航是有效的,但需要进一步研究可持续性.
- 关于任务转移和整合的证据是混合的,需要更多地关注下游影响.
结论:
- 系统层面的干预措施对于改善PrEP吸收至关重要,但需要进一步研究有效性和可持续性.
- 解决个人,诊所和医疗保健系统的相互作用对于最大限度地提高PrEP结果至关重要.
- 量身定制的护理导航显示出克服PrEP使用决定因素的重大前景.
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