适应性艾滋病毒暴露前预防,南非约翰内斯堡的年轻女性的坚持干预措施:一个连续的多重分配随机试验
Jennifer Velloza1, Nicole Poovan2, Allison Meisner3
1Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
The lancet. HIV
|December 16, 2024
概括
暴露前预防 (PrEP) 坚持支持策略,包括短信和WhatsApp,在改善南非年轻女性的坚持方面没有显著差异. 在资源有限的环境中,需要进一步研究可扩展的解决方案.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 数字健康干预措施 数字健康干预措施
背景情况:
- 年轻的非洲妇女面临着每日口服暴露前预防 (PrEP) 的低坚持.
- 多层次的支持策略对于改善PrEP在这个人口群体中的坚持至关重要.
- 这项研究评估了在南非约翰内斯堡启动PrEP的年轻女性可扩展的坚持支持策略.
研究的目的:
- 评估两种潜在可扩展的适应性支持策略的有效性,用于启动PrEP的年轻女性.
- 为了比较每周一次的双向短信通信与参与WhatsApp同行支持组.
- 评估强化干预措施 (以问题为重点或药物级反咨询) 对于具有低坚持的参与者.
主要方法:
- 一个连续的多重分配随机试验与开始 PrEP 的年轻女性 (18-25岁) 进行.
- 参与者被随机分配到双向短信或WhatsApp同行支持小组.
- 在第3个月的低坚持导致随机化到强化咨询手臂 (以问题为中心或药物级反).
主要成果:
- 在双向短信手臂 (20%) 和WhatsApp手臂 (18%) 之间,在9个月的PrEP坚持没有观察到显著差异.
- 强化干预也没有显著的差异,在药物水平反 (5%) 和月度咨询 (4%) 两种手臂的低坚持率在9个月的月份也没有显著差异.
- 所有报告的严重不良事件与试验干预无关.
结论:
- 无论是SMS还是WhatsApp的同行支持干预措施都没有显著改善约翰内斯堡年轻女性对PrEP的坚持.
- 目前的坚持支持策略可能对这个人群来说不够.
- 需要进一步的研究来确定有效和可扩展的PrEP支持方法,以帮助资源有限的年轻女性.
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