美国2018-2022年PrEP年化药片日覆盖率的不平等:一个横截面的药物公平性分析
Patrick S Sullivan1, Eric Hall2, Heather Bradley1
1Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Journal of the International AIDS Society
|May 14, 2025
概括
暴露前预防 (PrEP) 覆盖范围因种族,性别和年龄而异,可能掩盖了预防艾滋病毒的不平等. 评估PrEP公平性需要评估所涵盖的药物使用日,而不仅仅是用户数量.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 预防艾滋病毒 预防艾滋病毒
背景情况:
- 暴露前预防 (PrEP) 对于降低艾滋病毒感染风险至关重要.
- 人口层面的影响取决于PrEP的覆盖率和在那些适用于使用的人群中持久性.
研究的目的:
- 分析不同种族/族群,性别和年龄类别PrEP持久性的变化.
- 评估PrEP剂量指南对药物坚持的影响.
主要方法:
- 利用美国商业药房数据识别PrEP用户并计算PrEP覆盖日 (PDC).
- 根据性别,种族/种族和年龄组分析PDC,比较2018年和2022年的数据,以评估2-1-1剂量影响.
主要成果:
- 2018年PrEP使用者从225180人增加到2022年459984人.
- 2022年PDC中位数为167天,观察到显著差异:男性 (180天) 的PDC高于女性 (90天).
- 白人非西班牙裔用户的PDC (290天) 比西班牙裔 (268天) 或黑人非西班牙裔用户 (251天) 高. 老年使用者也比年轻人显示出更大的PDC.
结论:
- 目前的PrEP计划评估可能会掩盖由于覆盖日数不同而造成的保护不平等.
- 在妇女,黑人,西班牙裔和年轻人群体中,PrEP 覆盖日数存在显著差异.
- 包括PDC在内的药物公平性评估对于全面评估PrEP公平性至关重要.
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