在注射毒品的人群中实施预暴露预防 (PrEP) 促进干预:社区和研究实施伙伴的观点
Charles A Warnock1, Colleen Mistler2, Adam Viera3
1Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA; Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA.
Journal of substance use and addiction treatment
|March 8, 2025
概括
为注射毒品的人 (PWID) 实施应急管理 (CM) 与PrEP遵守和支持服务 (PASS) 面临诸如员工流动等障碍. 在场外整合服务可以提高艾滋病毒预防的覆盖率.
科学领域:
- 实施科学 实施科学
- 公共卫生干预措施 公共卫生干预措施
- 艾滋病毒预防研究 预防研究
背景情况:
- 临床指导方针建议在注射药物 (PWID) 预防艾滋病毒的人中进行暴露前预防 (PrEP).
- 在PWID中,基于证据的艾滋病毒预防干预措施的范围有限,这给公共卫生带来了重大挑战.
- 在临床试验中,正在评估与PrEP遵守和支持服务 (PASS) 的分级护理的应急管理 (CM).
研究的目的:
- 从实施合作伙伴中获得关于采用基于CM的PREP干预包用于PWID的障碍和促进者的观点.
- 描述社区和研究伙伴对基于证据的研究实践的看法.
- 确定在社区环境中成功实施和可持续性艾滋病毒预防服务的战略.
主要方法:
- 在2023年10月进行了三个焦点小组,其中包括社区站点工作人员 (n=8),站点领导 (n=6) 和研究协调员 (n=6).
- 卫生服务研究实施促进行动 (PARIHS) 框架指导了定性数据收集和分析.
- 数据收集的重点是与干预相关的证据,背景和促进机会.
主要成果:
- 参与者报告了CM的初始观点,这些观点随着试验参与而有所改善;之前的研究经验和基础设施促进了实施.
- 社区环境中的挑战包括竞争的社会需求,员工流动和倦怠,阻碍了PWID中PrEP推广.
- 建议的便利化机会包括将干预措施整合到现场外展服务中,并增加CM会议;强调了研究团队的持续存在和详细的结果沟通.
结论:
- 确定了在社区环境中实施和维持基于CM的PrEP推广干预措施的障碍和促进者.
- 预测和解决人员能力和流动性对于社区环境中的艾滋病毒预防干预至关重要.
- 将基于CM的PrEP推广整合到场外服务中,可能会提高PWID的覆盖率.
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