转向性风险行为查是否影响了对人类免疫缺陷病毒暴露前和暴露后预防治疗的推迟?
Mindy Goldman1,2, Samra Uzicanin1, Sheila F O'Brien1,3
1Canadian Blood Services, Medical Affairs and Innovation, Ottawa, Ontario, Canada.
Vox sanguinis
|November 21, 2024
概括
加拿大血液服务局在改变捐赠者查标准后,对暴露前预防 (PrEP) 的推迟略有增加. 这种转向基于风险的评估影响了PrEP和暴露后预防 (PEP) 对人类免疫缺陷病毒 (HIV) 的延期.
科学领域:
- 献血安全和公共卫生政策
- 人类免疫缺陷病毒 (HIV) 预防的流行病学.
背景情况:
- 加拿大血液服务局以前根据HIV暴露前或暴露后预防 (PrEP/PEP) 已经过去了的时间推迟了捐赠者.
- 对病毒动力学变化的担忧促使推迟政策.
- 一个政策变化将捐赠者推迟标准从基于时间的转移到性风险行为.
研究的目的:
- 评估从基于时间的性风险行为标准过渡到推迟血液捐献者推迟PrEP/PEP的影响.
- 评估人类免疫缺陷病毒 (HIV) 暴露前预防 (PrEP) 和暴露后预防 (PEP) 的延期率的变化.
主要方法:
- 关于PrEP/PEP延期代码的数据是从国家流行病学数据库提取的.
- 分析涵盖了政策变化之前和之后的22个月.
- 对两个时期的延期率进行了比较.
主要成果:
- 暴露后预防 (PEP) 的延期在统计学上保持稳定.
- 暴露前预防 (PrEP) 推迟显著增加,从每10万次捐献的5.9增加到12.4.
- 仅为PrEP使用而推迟的捐赠者更有可能是男性,年轻人和首次捐赠者.
结论:
- 向性风险行为标准的转变导致了PrEP推迟的适度增加.
- 由于自我推迟和增加PrEP使用,可能低估了推迟影响.
- 在不断发展的艾滋病毒预防策略的背景下,对捐赠者查有效性的进一步评估是有必要的.
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