通过电话来提高肯尼亚妇女获得分娩后护理的PrEP持续性:一个集群随机试验
Renee Heffron1,2, Lydia Etyang3, Bernard Nyerere4
1Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
Frontiers in reproductive health
|December 15, 2025
概括
在肯尼亚,将艾滋病毒暴露前预防 (PrEP) 整合到堕胎后护理 (PAC) 中显示了较低的吸收率,但通过增强的电话支持改善了持续性. 这种干预措施增加了年轻女性面临双重艾滋病毒和怀孕风险的PrEP补充和坚持.
科学领域:
- 公共卫生 公共卫生
- 生殖健康 生殖健康
- 预防传染病 预防传染病
背景情况:
- 肯尼亚的年轻女性经历了高艾滋病毒率和意外怀孕.
- 将艾滋病毒暴露前预防 (PrEP) 纳入生殖健康服务,包括流产后护理 (PAC),并不常见.
- 需要评估PrEP的吸收率,持续性以及PAC环境中的坚持干预措施的影响.
研究的目的:
- 在肯尼亚寻求PAC的妇女中估计PrEP的吸收和持久性.
- 与标准护理 (SOC) 相比,对PrEP持续性和使用的增强坚持干预 (电话) 的有效性进行评估.
- 识别PAC内部PrEP服务提供方面的差距.
主要方法:
- 在肯尼亚的PAC诊所进行了一个集群随机试验.
- 临床被随机分配为提供增强的支持 (结构化电话) 或SOC用于PrEP的坚持和保留.
- 主要结局是1个月后重新补充PrEP;通过尿液诺福维尔检测来评估坚持.
主要成果:
- 在4,112名寻求PAC的女性中,655名 (15.9%) 开始了PrEP.
- 在第1个月的PrEP补充剂在增强支臂 (15.4%) 与SOC (5.7%) 相比显著更高.
- 在第1个月的尿液中检测到的特诺福维尔在增强手臂 (19.0%) 和SOC (9.4%) 中也更高.
结论:
- 在提供PrEP信息和咨询方面存在显著的差距,导致PAC最初的吸收率较低.
- 虽然整体持久性和坚持性很低,但增强的电话支持干预在第1个月显示了统计学上显著的改善.
- 进一步调查优化在PAC环境中对PrEP的坚持支持是有必要的.
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