暴露前预防 处方 处方 状态 和 HIV-1 感染
Li Tao1, Juan Yang1, Joshua Gruber1
1Gilead Sciences Inc, Foster City, California.
JAMA network open
|December 4, 2025
概括
暴露前预防 (PrEP) 覆盖的障碍,如索赔拒绝和延迟,增加了HIV-1发病率. 解决这些问题对于有效的HIV-1预防和减少传播至关重要.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 暴露前预防 (PrEP) 是一种非常有效的HIV-1预防策略.
- 持续存在的PrEP吸收障碍,包括表单覆盖问题,限制了其有效性.
- 了解这些障碍对于优化HIV-1预防工作至关重要.
研究的目的:
- 评估PrEP药物的临床配方覆盖范围.
- 识别PrEP吸收的障碍及其与HIV-1发病率的关联.
- 分析发放状态对累积HIV-1发病率的影响.
主要方法:
- 使用美国药房索赔数据的回顾性观察队列研究 (2021年1月 - 2023年12月).
- 分析包括接受各种口服和注射PrEP方案的HIV-1阴性成年人.
- 通过申请拒绝原因,发放状态,付款人类型和共同付款来评估表单覆盖率;与PrEP发放状态相关的HIV-1发病率.
主要成果:
- 与那些被拒绝或放弃PrEP申请的人相比,那些被放弃申请的人有更高的HIV-1发病率.
- 处方延迟1-7天与艾滋病毒-1感染率的增加有关.
- 通用emtricitabine/tenofovir disoproxil fumarate (gF/TDF) 的发行概率高于其他方案;增加成本共享降低了发行概率.
- 缺少表单覆盖率是申请被拒绝的主要原因 (29.2%).
结论:
- 较高的HIV-1发病率与PrEP索赔发放问题有关,包括拒绝和放弃.
- 需要有针对性的战略来改善PrEP申请处理和克服与付款人相关的障碍.
- 解决这些障碍对于降低HIV-1传播率至关重要.
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