Packaging PrEP to Prevent HIV: An Integrated Framework to Plan for Pre-Exposure Prophylaxis Implementation in Clinical Practice.

Packaging PrEP to Prevent HIV: An Integrated Framework to Plan for Pre-Exposure Prophylaxis Implementation in Clinical Practice.
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包装准备以防止艾滋病毒:一个综合框架,以计划在临床实践中实施暴露前预防。

DOI:
10.1097/qai.0b013e3181e8efe4
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发表时间:
2010-09
期刊:
Journal of acquired immune deficiency syndromes (1999)
影响因子:
--
通讯作者:
Mayer K
Mayer K
中科院分区:
其他
文献类型:
--
作者:
Underhill K;Operario D;Skeer M;Mimiaga M;Mayer K

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抗逆转录病毒暴露前预防(PrEP)药物可能对预防艾滋病毒传播部分有效。在对临床试验结果的预期中,行为艾滋病预防科学家已经开始研究在临床实践或社区环境中实施PrEP可能面临的挑战。这些努力已经认识到有必要通过降低风险的咨询和持续的艾滋病毒检测来补充PrEP药物的提供,我们建议有必要提供更广泛的临床、诊断、行为和监测服务,以支持PrEP作为一种人口层面的艾滋病毒预防战略。本评论提供了一个在临床实践中优化PrEP给药的综合结构,包括五个组成部分:1)PrEP药物;2)安全筛查和重复HIV检测;3)行为干预,促进PrEP的启动,保持依从性,并尽量减少风险补偿;4)制定战略,使PrEP使用者和卫生保健系统长期参与;5)种群水平监测。我们简要概述了每个组件,并重点介绍了这个由五部分组成的包的实现含义。试图在没有明确解决非药物因素的情况下制定扩大计划,可能会忽视关键的实施需求、障碍和促进因素。
Antiretroviral pre-exposure prophylaxis (PrEP) drugs may be partially effective for preventing HIV transmission. In anticipation of clinical trial results, behavioral HIV prevention scientists have begun examining possible challenges in the implementation of PrEP in clinical practice or community settings. These efforts have acknowledged the need to supplement PrEP drug delivery with risk-reduction counseling and ongoing HIV testing, and we suggest that an even wider range of clinical, diagnostic, behavioral, and monitoring services will be necessary to support PrEP as a population-level HIV prevention strategy. This Commentary offers an integrated structure for optimizing PrEP delivery in clinical practice, which includes five components: 1) PrEP drugs; 2) safety screening and repeated HIV testing; 3) behavioral interventions to facilitate PrEP initiation, maintain adherence, and minimize risk compensation; 4) the development of strategies to engage PrEP users and the healthcare system over the long term; and 5) population-level monitoring. We provide a brief overview of each component and highlight implications of this five-part package for implementation. Attempts to plan for scale-up without explicitly addressing non-pharmaceutical elements may overlook critical implementation needs, barriers, and facilitators.
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