A Randomized Study of Passive versus Active PrEP Patient Navigation for a Heterogeneous Population at Risk for HIV in South Florida
A Randomized Study of Passive versus Active PrEP Patient Navigation for a Heterogeneous Population at Risk for HIV in South Florida
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DOI：
10.1177/2325958219848848
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Feaster, Daniel
中科院分区：
文献类型：
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作者：
Doblecki-Lewis, Susanne;Butts, Stefani;Feaster, Daniel
有效的方法，以促进暴露前预防（PrEP）和链接到那些谁可能受益最大的PrEP护理已被证明是一个重大的挑战。我们设计并试点测试了基于优势的病例管理（SBCM）干预PrEP联系。对PrEP感兴趣并符合标准的成年人（n = 61）被随机分配到被动转诊（对照）或主动SBCM（治疗）。测量的结果是提供者访问的完成，PrEP的启动，以及PrEP启动的时间。总体而言，34%的患者在12周内启动了PrEP：对照组9例（29%），治疗组12例（40%）。开始PrEP的平均时间为13.1周（95%置信区间，12.0-14.2），组间无差异（P = .382）。治疗组和对照组之间在12周内实现提供者访问的差异为21%（53.3%对32.3%）（P = 0.096）。参与者遇到了财政，后勤，社会和提供者相关的障碍，以获得PrEP。基于优势的病例管理的患者导航是一种很有前途的策略，可以帮助PrEP寻求者获得医疗服务提供者的访问并启动PrEP。
Effective approaches to promoting pre-exposure prophylaxis (PrEP) and linkage to PrEP care among those who may benefit the most from PrEP has proven to be a major challenge. We designed and pilot tested a strengths-based case management (SBCM) intervention for PrEP linkage. Adults interested in PrEP and meeting criteria (n = 61) were randomized to passive referral (control) or active SBCM (treatment). Outcomes measured were completion of provider visit, initiation of PrEP, and time to initiation of PrEP. Overall, 34% initiated PrEP by 12 weeks: 9 (29%) in the control group and 12 (40%) in the treatment group. The mean time to PrEP initiation was 13.1 weeks (95% confidence interval, 12.0-14.2) with no difference between groups (P = .382). There was a 21% difference in achieving a provider visit between the treatment and control groups (53.3% versus 32.3%) by 12 weeks (P = .096). Participants encountered financial, logistical, social, and provider-related barriers to PrEP access. Strengths-based case management-based patient navigation is a promising strategy for assisting PrEP seekers in obtaining a medical provider visit and initiating PrEP.