两个实施策略的实施和有效性结果的比较 Keep It Up! 数字艾滋病毒预防计划:一种3型混合有效性实施试验
Brian Mustanski1,2,3, Nanette Benbow4,5, Kathryn Macapagal4,6
1Impact Institute, Northwestern University, 625 N. Michigan Ave. Floor 14, Chicago, IL, 60611, USA. brian@northwestern.edu.
AIDS and behavior
|August 18, 2025
概括
基于社区的组织 (CBO) 为预防艾滋病毒而接触到更多高风险的与男性发生性关系的年轻人 (YMSM),但直接向消费者 (DTC) 更具成本效益. DTC策略提供了较低的成本,每次预防艾滋病毒感染.
科学领域:
- 公共卫生 公共卫生
- 数字健康干预措施 数字健康干预措施
- 预防艾滋病毒 预防艾滋病毒
背景情况:
- 数字艾滋病毒预防干预措施对于接触关键人群至关重要.
- 将基于社区的组织 (CBO) 与直接向消费者 (DTC) 交付模式进行比较对于优化实施和有效性至关重要.
- 与男性发生性关系的年轻男性 (YMSM) 是艾滋病毒预防工作的优先人口.
研究的目的:
- 为了比较两个交付策略 (CBO与DTC) 的实施和有效性结果,用于数字艾滋病毒预防干预 (Keep It Up! ) 的情况.
- 为了评估在两个交付手臂中在YMSM中招募,参与和艾滋病毒风险行为.
- 评估每个传递策略预防艾滋病毒感染的成本效益.
主要方法:
- 一个III型混合有效性-实施试验,涉及2124名YMSM.
- 在基线和2019-2023年12周随访期间收集的数据.
- 在CBO和DTC手臂之间对招募人口统计,艾滋病毒风险因素,暴露前预防 (PrEP) 使用和每次感染避免的成本进行比较.
主要成果:
- 消费者直销 (DTC) 总体上招募了更多的参与者.
- 社区组织 (CBO) 招募了更高比例的黑人和拉丁裔青年男性男性,以及艾滋病毒风险较高的参与者.
- 暴露前预防 (PrEP) 的使用在两只手臂显著增加,在CBO手臂中观察到更大的增加. 与DTC相比,CBO交付避免了更多的艾滋病毒感染,但每次感染的成本较高.
结论:
- 虽然CBO的交付有效地达到高风险的YMSM和 PrEP使用量的增加,但DTC策略在避免艾滋病毒感染方面表现出更高的成本效益.
- 调查结果表明,DTC数字艾滋病毒预防干预措施可能是一个更具成本效益的方法,可以覆盖更广泛的人口.
- 在选择数字艾滋病毒预防的最佳交付策略时,应与成本同时考虑实施和有效性.
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