Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?
Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?
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DOI：
10.1007/s11904-019-00437-6
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发表时间：
2019-04-01
影响因子：
4.6
通讯作者：
Mugwanya, Kenneth
中科院分区：
文献类型：
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作者：
O'Malley, Gabrielle;Barnabee, Gena;Mugwanya, Kenneth
临床试验发现，PrEP在降低不同暴露类型、性别、PrEP方案和给药方案的艾滋病毒感染风险方面非常有效。迫切需要证据来为扩大预防措施提供信息，以实现世卫组织/联合国艾滋病规划署到2020年使300万人接受预防措施的宏伟目标。最近的发现大规模提供艾滋病毒服务的成功模式是从多年的正式研究和规划证据发展而来的。这些努力产生了与扩大PrEP提供相关的经验教训，包括简化实验室检测、扩大处方和管理权限、区分药物获取点以及减少污名化和家长同意使用PrEP的障碍的重要性。特别需要在区分预防措施与抗逆转录病毒治疗的领域进行进一步的研究，包括重复艾滋病毒检测以确保艾滋病毒呈阴性，以及确定和衡量有效的预防依从性。15年来抗逆转录病毒药物推广的证据可以立即为提供预防措施的公共卫生方法提供信息。
Purpose of ReviewClinical trials have found that PrEP is highly effective in reducing risk of HIV acquisition across types of exposure, gender, PrEP regimens, and dosing schemes. Evidence is urgently needed to inform scale-up of PrEP to meet the ambitious WHO/UNAIDS prevention target of 3,000,000 individuals on PrEP by 2020.Recent FindingsSuccessful models of delivering HIV services at scale evolved from years of formal research and programmatic evidence. These efforts produced lessons-learned relevant for scaling-up PrEP delivery, including the importance of streamlining laboratory tests, expanding prescription and management authority, differentiating medication access points, and reducing stigma and barriers of parental consent for PrEP uptake. Further research is especially needed in areas differentiating PrEP from ART delivery, including repeat HIV testing to ensure HIV negative status and defining and measuring prevention-effective adherence.SummaryEvidence from 15years of ART scale-up could immediately inform a public health approach to PrEP delivery.