一项观察性队列研究,通过佛罗里达州迈阿密-戴德县的一个社区移动诊所评估PrEP的覆盖范围,参与度和持久性
Susanne Doblecki-Lewis1, Ariana Johnson2, Katherine Klose1
1Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
Journal of the International AIDS Society
|October 15, 2024
概括
移动诊所显著改善了 cisgender 女性和黑人客户获得暴露前预防 (PrEP) 的机会. 这种方法也增加了PrEP的持续性,证明了它在预防艾滋病毒方面的价值.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 健康 公平 卫生 公平
背景情况:
- 暴露前预防药物 (PrEP) 获取障碍阻碍了其到达优先人群.
- 基于社区的移动诊所为扩大PrEP参与提供了一个有希望的策略.
- 这项研究评估了佛罗里达州迈阿密-戴德县移动诊所与固定诊所的有效性.
研究的目的:
- 通过固定和移动社区诊所提供的暴露前预防 (PrEP) 服务的覆盖范围和持续性进行比较.
- 在不同的临床环境中确定与PrEP持久性相关的人口和临床因素.
- 评估移动诊所战略对在艾滋病毒预防中参与代表性不足的人群的影响.
主要方法:
- 一项观察性队列研究分析了固定和移动诊所1896名客户的数据 (2018年8月至2023年3月).
- 卡普兰-梅尔曲线评估了PrEP和护理中的持久性 (在前24周内).
- 考克斯的比例危险模型评估了在48周内停止治疗的风险因素,考虑性别,种族,种族,保险和地点.
主要成果:
- 与固定诊所相比,移动诊所接触的女性更多 (32.1%对12.9%),黑人客户 (34.5%对13.1%),以及老年客户.
- 在移动诊所开始服务的客户更有可能继续PrEP到48周 (HR: 1.68,p<0.01).
- 没有保险的个人和男性在移动环境中也显示PrEP持久性增加.
结论:
- 一个移动诊所策略有效地增加了艾滋病毒暴露前预防 (PrEP) 的关键人群的覆盖范围,包括非性别女性和黑人客户.
- 移动诊所模型表明,与固定诊所相比,PrEP使用的持续性增加,突出了其额外的好处.
- 移动诊所是扩大艾滋病毒预防工作和解决健康差异的重要组成部分.
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