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在肯尼亚西部的年轻女性性工作者中,针对PrEP遵守的行为和结构干预措施

Kawango Agot¹, Domonique M Reed^2,3, Matthew R Lamb^4,5

¹Impact Research and Development Organization, Kisumu, Kenya.

AIDS and behavior

|March 15, 2026

概括

在肯尼亚,两项用于暴露前预防的坚持支持干预 (PrEP) 在年轻的女性性工作者中没有显著的效果差异. 研究结果表明,对于这种高发病率的人群,需要长效PrEP选项.

科学领域:

公共卫生公共卫生
传染性疾病传染性疾病
预防艾滋病毒预防艾滋病毒

背景情况:

肯尼亚的年轻女性性工作者 (YFSW) 面临着高艾滋病毒发病率.
始终坚持暴露前预防 (PrEP) 对于其有效性至关重要,但仍然是一个挑战.
随着COVID-19大流行,出现了可能影响研究依从性和研究结果的干扰.

研究的目的:

为了比较两个坚持支持干预措施 (同行支持与SMS提醒/资源转移) 的可行性,可接受性和有效性,在肯尼亚的YFSW中进行口服PrEP.
评估24个月的坚持性支持干预措施的持久性.
在艾滋病毒风险较高的人群中评估PrEP的有效性.

主要方法:

一项未盲目的随机对照试验招募了200名HIV阴性年轻女性,年龄在18-24岁之间.
参与者接受了口服PrEP,并随机分配到12个月的同行支持 (PS) 或短信提醒和资源转移 (RRT),随后是12个月没有干预.
在12个月,18个月和24个月使用血中诺福维尔水平和自我报告的坚持,评估了有效性.

主要成果:

在PS (3%,1%,0%) 和RRT (9%,9%,1%) 两只手臂之间在12,18和24个月后没有观察到可检测的血天诺福维尔水平的显著差异.
在整个研究过程中,自我报告的完美7天坚持在两支手臂保持高水平 (范围从76%到87%不等).
在随访期间发生了两次HIV血清转化.

结论:

无论是同行支持,还是短信提醒/资源转移,都没有显著改善这一群年轻人FSW的目标PrEP坚持 (血中tenofovir水平).
自我报告的高坚持率和低可检测的tenofovir水平之间的差异可能与COVID-19限制期间性活动减少有关.
迫切需要更有效的策略,例如长效PrEP配方,用于在YFSW中预防艾滋病毒.

关键词:

坚持的坚持坚持的坚持女性性工作者是什么意思肯尼亚肯尼亚肯尼亚肯尼亚暴露前预防暴露前预防

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