Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.
Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.
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DOI：
10.1007/s10461-016-1627-z
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发表时间：
2017-05
影响因子：
4.4
通讯作者：
Kennedy CE
中科院分区：
文献类型：
--
作者：
Koechlin FM;Fonner VA;Dalglish SL;O'Reilly KR;Baggaley R;Grant RM;Rodolph M;Hodges-Mameletzis I;Kennedy CE
每日口服暴露前预防(PrEP)是艾滋病毒阴性者使用抗逆转录病毒药物来预防艾滋病毒感染。世卫组织在2015年发布了新的指南，建议对所有有很大艾滋病毒感染风险的人群进行预防接种。为了准备这些指南，我们对可能受益于PrEP的人群、女性、异性恋男性、年轻女性和青春期女孩、女性性工作者、血清不一致的夫妇、变性人和注射药物的人以及可能开PrEP处方的医疗保健提供者的价值观和偏好进行了系统的审查。综合搜索战略审查了三个电子数据库的文章和与艾滋病毒有关的会议摘要(1990年1月至2015年4月)。数据摘要使用标准化的表格，按人口群体和相关主题进行分类。在筛选的3068篇引文中，包括76篇同行评议文章和28篇会议摘要。地理上的报道是全球性的。大多数研究(N=1078)评估了PrEP的假设使用，而26项研究包括实际服用PrEP或安慰剂的个人。对PrEP的认识很低，但一旦向参与者提供了关于PrEP的信息，大多数人表示他们会考虑使用它。对安全性、副作用、成本和有效性的担忧是最常被提及的使用障碍。几乎没有风险补偿的迹象。医疗保健提供者会考虑开PrEP，但在这样做之前需要更多的信息。来自迅速扩大的证据基础的研究结果表明，大多数最有可能受益于PrEP的人群对它持积极态度。这些人口将受益于在尽可能短的时间内克服目前的执行挑战。
Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990–April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.