在美国提供公平的暴露前预防服务方面的创新:扩大非传统环境中的获取
Joanne E Mantell1, Laurie J Bauman2, Stephen Bonett3
1HIV Center for Clinical and Behavioral Studies, Department of Psychiatry and the NYS Psychiatric Institute, Columbia University, New York, NY.
Journal of acquired immune deficiency syndromes (1999)
|March 31, 2025
概括
创新策略正在扩大弱势群体获得暴露前预防 (PrEP) 的机会,利用社区组织,远程医疗,移动诊所,药房和急诊室克服医疗保健障碍.
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 (PrEP) 的使用正在增加,但在人口和地理上面临着持续的差异.
- 对PrEP公平性的关键障碍包括耻辱,医生不信任,缺乏以患者为中心的护理,以及对这些问题的系统性忽视.
研究的目的:
- 描述在非传统环境中向服务不足的人群提供PrEP的五种实施策略.
- 通过基于股权的方法来解决PrEP不平等的结构性决定因素.
主要方法:
- 在社区组织中实施PrEP服务.
- 使用telePrEP来克服后勤障碍.
- 部署移动诊所,直接为社区提供服务.
- 利用药房提供方便的PrEP接入.
- 在急诊室内整合PrEP的交付.
主要成果:
- 社区组织是性健康服务的可信度中心,包括PrEP.
- 远程医疗和移动诊所有效地解决了运输和安排障碍.
- 药房提供了一个方便的,以社区为基础的PrEP获取选项.
- 紧急服务部门可以接触目前没有定期护理的个人.
结论:
- 替代PrEP交付模式扩大了获取机会,并减轻了传统环境中存在的障碍.
- 虽然这些方法并不能消除所有不平等现象,但这些方法增加了接触更广泛人群的可能性.
- 提供多样化的PrEP接入点可以提高整体PrEP使用率和艾滋病毒预防工作.
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