犯错是人性的,坚持是邪恶的:我们是否在注射PrEP中再次重复同样的成本和保险覆盖错误?
Alexa B D'Angelo1, Viraj V Patel2, Adam W Carrico3
1CUNY Institute for Implementation Science in Population Health, New York, NY.
Journal of acquired immune deficiency syndromes (1999)
|December 2, 2025
概括
注射式暴露前预防 (PrEP) 显示出高度兴趣,但由于进入障碍,其吸收率较低. 从cabotegravir推广中吸取的教训可以为预防艾滋病毒的lenacapavir实施提供信息.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 生物医学干预 生物医学干预
背景情况:
- 长效注射性暴露前预防 (PrEP) 是预防艾滋病毒的重大进展.
- 高昂的成本和获取问题限制了当前注射PrEP配方的覆盖范围,例如cabotegravir.
- 这些挑战预计将影响像莱纳卡巴维尔这样的新型长效注射剂的吸收.
研究的目的:
- 评估弱势群体对长效注射PrEP的兴趣和吸收情况.
- 识别进入和维持长效注射PrEP的障碍.
- 基于对cabotegravir的经验,为未来的lenacapavir推出提供见解.
主要方法:
- 一个在线的美国国家队列研究.
- 包括高危感染艾滋病毒的性和性别少数群体.
- 从2022年到2025年收集PrEP兴趣和吸收的纵向数据.
主要成果:
- 61%的参与者对每两个月注射一次的PrEP表示兴趣.
- 摄入量仍然很低,只有42人开始服用,57人在24个月后注射PrEP.
- 关键障碍包括提供者/诊所层面的问题,保险覆盖和成本.
结论:
- 尽管最初的兴趣很高,但注射PrEP的吸收受到重大进入障碍的限制.
- 保险覆盖和诊所级物流方面的挑战阻碍了一致的访问.
- 分析cabotegravir的推出挑战对于优化lenacapavir的实施和改善艾滋病毒预防的准入至关重要.
相关概念视频
01:21Drug Accumulation During Multiple Dosing: Repetitive IV Injections
221
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
221
01:27Insulin Formulations: Types and Delivery
597
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
597
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
209
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
209
01:16Insulin: Dosing Regimen and Adverse Effects
644
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
644
01:01Dosage Regimen: Fixed Dose
2.3K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
2.3K
01:19Pharmaceutical Alternatives: Excipients and Impurities-Related Therapeutic Nonequivalence
148
Pharmaceutical products contain more than just the active drug; they also contain various excipients such as binders, solubilizers, stabilizers, preservatives, and other elements. In some cases, impurities or contaminants might be present. Traditionally, quality control in pharmaceuticals has primarily focused on the analysis of the active drug, often overlooking the impact of these additional components. The recent issue with heparin contamination by over-sulfated chondroitin sulfate, a...
148