自COVID-19开始以来,注射器服务计划中的HIV预防:我们从这里走到哪里?
Mary A Hatch1, Melissa Ertl2, David Closs3
1Addictions, Drug & Alcohol Institute, Department of Psychiatry & Behavioral Sciences, University of Washington, 1959 NE Pacific St., Box 356560, Seattle, WA, 98195-6560, USA. hatchm@uw.edu.
Current HIV/AIDS reports
|January 15, 2025
概括
暴露前预防 (PrEP) 是有效的预防艾滋病毒,但使用毒品的人 (PWUD) 面临着复杂的挑战. 解决健康的社会决定因素对于成功预防艾滋病毒在减伤计划中至关重要.
科学领域:
- 公共卫生 公共卫生
- 预防传染病 预防传染病
- 减少伤害 减少伤害
背景情况:
- 随着COVID-19大流行,医疗保健的提供发生了重大变化,影响了使用毒品的人 (PWUD) 的艾滋病毒预防策略.
- 注射器服务计划 (SSP) 在为PWUD提供减少伤害服务和艾滋病毒预防工具方面至关重要.
- 暴露前预防 (PrEP) 是一种高效的生物医学干预措施,用于预防艾滋病毒,如果始终使用.
研究的目的:
- 审查2020年后在SSP的PWUD中PrEP使用和遵守PWUD的挑战.
- 确定将PrEP整合到减少危害服务中的障碍和促进者.
- 为PWUD提供优化艾滋病毒预防的建议.
主要方法:
- 叙事综述综合现有文献和临床经验.
- 分析由于COVID-19流行病导致SSP的运营变化.
- 在个人,提供者和结构层面对挑战的描述.
主要成果:
- 与流行病相关的变化为PrEP的提供和采用在PWUD中创造了新的障碍.
- PWUD遇到多方面的挑战,包括个人态度,提供者偏见和PrEP参与的系统障碍.
- 目前SSP中的PrEP模型在解决PWUD复杂需求方面面临局限性.
- 在解决更广泛的社会和结构性健康决定因素之前,PrEP的遵守往往会受到阻碍.
结论:
- 对于PWUD来说,有效的艾滋病毒预防需要量身定制的,全身的方法,考虑除了生物医学干预之外的因素.
- 在解决潜在的社会和结构问题之前,PrEP可能不是所有PWUD的现实初级预防工具.
- 降低危害的计划应整合全面的战略,支持各种风险降低需求.
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