Predictors of Human Immunodeficiency Virus Pre-Exposure Prophylaxis (PrEP) Uptake in a Sexual Health Clinic With Rapid PrEP Initiation.
Predictors of Human Immunodeficiency Virus Pre-Exposure Prophylaxis (PrEP) Uptake in a Sexual Health Clinic With Rapid PrEP Initiation.
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DOI：
10.1093/ofid/ofad060
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发表时间：
2023-03
影响因子：
4.2
通讯作者：
Little, Susan J.
中科院分区：
文献类型：
--
作者：
Wagner, Gabriel A.;Wu, Kuan-Sheng;Anderson, Christy;Burgi, Alina;Little, Susan J.
提高暴露前预防 (PrEP) 的吸收对于人类免疫缺陷病毒 (HIV) 预防举措至关重要。在进行 HIV 和性传播感染 (STI) 检测时提供 PrEP 可以提高接受率。我们在性健康诊所提供快速 PrEP 启动服务，并评估了 PrEP 兴趣、启动、关联和保留的预测因素。 2018 年 11 月至 2020 年 2 月期间，符合 PrEP 资格的个人前往性健康诊所就诊，可获得 30 天的免费 PrEP 以及与持续 PrEP 护理的联系。对人口和 HIV 风险数据进行单变量和多变量分析，以确定 PrEP 摄取的预测因素。在 1259 名符合 PrEP 资格的成年人中（99.7% 为男性，42.7% 为白人，36.2% 为西班牙裔），456 人对 PrEP 感兴趣，249 人开始了 PrEP，209 人有联系，67 人继续接受护理。 PrEP 兴趣的预测因素包括年龄较小 (P < .01)、月收入较低 (P = .01)、消遣性药物使用 (P = .02) 和性伴侣数量较多 (P < .01)。 PrEP 启动的负面预测因素包括月收入较低 (P = .04)、衣原体检测呈阳性 (P = .04) 和以金钱换取性行为 (P = .01)。连锁的负面预测因素包括自我认同为黑人 (P = .03) 和性传播感染检测呈阳性 (P < .01)。拥有健康保险可以积极预测关联（P < .01）和保留（P < .03）。少数符合 PrEP 资格的 HIV 和 STI 测试人员在提供 PrEP 时就开始了 PrEP，这表明仅在性健康诊所轻松获得 PrEP 可能无法提高采用率。吸收的预测因素包括已确定的艾滋病毒风险因素和较高社会经济地位的标志，这表明那些意识到自己的风险并有能力利用卫生服务的人最适合该模型。在性健康诊所提供快速 PrEP 的合格成年人中，1259 名成人中只有 67 名 (5.3%) 在 3 个月后继续接受护理。 PrEP 摄入的预测因素包括 HIV 风险行为和较高的社会经济地位。
Improved pre-exposure prophylaxis (PrEP) uptake is essential for human immunodeficiency virus (HIV) prevention initiatives. Offering PrEP at the time of HIV and sexually transmitted infection (STI) testing can improve uptake. We offered rapid PrEP initiation in a sexual health clinic and assessed predictors of PrEP interest, initiation, linkage, and retention. Between November 2018 and February 2020, PrEP-eligible individuals who presented to a sexual health clinic were offered a free 30-day supply of PrEP plus linkage to continued PrEP care. Univariable and multivariable analyses of demographic and HIV risk data were conducted to determine predictors of PrEP uptake. Of 1259 adults who were eligible for PrEP (99.7% male, 42.7% White, 36.2% Hispanic), 456 were interested in PrEP, 249 initiated PrEP, 209 were linked, and 67 were retained in care. Predictors of PrEP interest included younger age (P < .01), lower monthly income (P = .01), recreational drug use (P = .02), and a greater number of sexual partners (P < .01). Negative predictors of PrEP initiation included lower monthly income (P = .04), testing positive for chlamydia (P = .04), and exchanging money for sex (P = .01). Negative predictors of linkage included self-identifying as Black (P = .03) and testing positive for an STI (P < .01). Having health insurance positively predicted both linkage (P < .01) and retention (P < .03). A minority of PrEP-eligible HIV and STI testers initiated PrEP when offered, suggesting that easy PrEP access in sexual health clinics alone may not improve uptake. Predictors of uptake included established HIV risk factors and markers of higher socioeconomic status, suggesting that those aware of their risk and with the means to utilize health services engaged best with this model. Among eligible adults offered rapid PrEP in a sexual health clinic, only 67 of 1259 (5.3%) were retained in care at 3 months. Predictors of PrEP uptake included HIV risk behaviors and higher socioeconomic status.
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作者：
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通讯作者：
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DOI：
10.1097/qai.0000000000002638
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