为变革做好准备:利用质量改进为无家可归的青年和年轻人提供艾滋病毒PREP
Melanie Watt Ramos1, Jelina Marie Castillo1, Stefan Breitling1
1Division of Adolescent Medicine and Sports Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
概括
对无家可归的年轻人实施内部处方,显著增加了获得艾滋病毒暴露前预防 (PrEP) 的机会. 这一举措改善了无家可归的有风险年轻人对PrEP的采用.
科学领域:
- 公共卫生 公共卫生
- 预防传染病 预防传染病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 13-24岁的年轻人,特别是那些经历过无家可归 (YEH) 的年轻人,不成比例地受到艾滋病毒的影响.
- 有效的艾滋病毒暴露前预防 (PrEP) 可用,但年轻人面临着很大的障碍.
研究的目的:
- 在无家可归者庇护所关联诊所内识别有风险的YEH.
- 开发和实施一套内部的PrEP处方流程,以提高该群体的可访问性.
主要方法:
- 使用了一个改进框架模型与计划-做-研究-行动 (PDSA) 周期.
- 进行了利益相关者采访,并建立了社区伙伴关系.
- 专注于识别符合条件的患者,并为低资源,没有保险的人群提供处方.
主要成果:
- 符合条件的YEH的临床查从0%增加到98%.
- 在内部处方之前,92%的患者被转诊,没有年轻人启动PrEP.
- 在实施内部处方后,79%的符合条件和感兴趣的年轻人获得了PrEP处方.
结论:
- 增加查和社区伙伴关系对于加强在风险年轻人中获得PrEP的机会至关重要.
- 公司内部的处方模式有效地克服了这种脆弱人群中PrEP吸收的障碍.
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