Evaluation of an HIV Pre-Exposure Prophylaxis Referral System: From Sexual Health Center to Federally Qualified Health Center Pre-Exposure Prophylaxis Clinic.
Evaluation of an HIV Pre-Exposure Prophylaxis Referral System: From Sexual Health Center to Federally Qualified Health Center Pre-Exposure Prophylaxis Clinic.
复制标题
HIV 暴露前预防转诊系统的评估：从性健康中心到联邦合格的健康中心暴露前预防诊所。
DOI：
10.1089/apc.2021.0050
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发表时间：
2021
影响因子：
4.9
通讯作者：
Clement,MeredithEdwards
中科院分区：
文献类型：
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作者：
Lillis,Rebecca;Beckford,Jeremy;Fegley,Joshua;Siren,Julia;Hinton,Bruce;Gomez,Samuel;Taylor,StephanieN;Butler,Isolde;Halperin,Jason;Clement,MeredithEdwards
需要创新的交付战略，以促进获得艾滋病毒暴露前预防（PrEP）。本研究的目的是评估导航器促进PrEP转诊过程从性健康中心（SHC）到位于同一地点的PrEP诊所作为替代交付模式。电子健康记录（EHR）数据用于计算2019年在SHC就诊的客户数量。手动审查图表，以确定是否进行了PrEP诊所转诊，并记录转诊方法的类型：与导航员面对面的预约安排（热交接），向导航员发送EHR消息以安排稍后的预约（EHR消息），或向客户提供导航员的联系信息（仅卡）。在2019年，2481独特的潜在PrEP资格的客户被视为在SHC; 220（9%）收到了PrEP转介。在转介的客户中，中位年龄为30岁（四分位数范围，24-34），182人（83%）为男性，89人（40%）为非西班牙裔黑人，24人（11%）为拉丁裔。总的来说，94/220（43%）被转介的客户参加了与提供者的初始PrEP访问，通过转介方法参加的比例分别为81%，36%和27%，分别为热传递，EHR消息和卡片（p< 0.0001）。尽管这两个诊所合用同一地点，但该转诊系统的PrEP护理连续体沿着仍有显著下降。温暖的交接是最有效的转介方法，但需要进一步的努力，以了解转介的障碍。在SHC实施当天PrEP服务是吸引更多客户的一个潜在解决方案。
Innovative delivery strategies are needed to facilitate access to HIV pre-exposure prophylaxis (PrEP). The objective of this study was to evaluate a navigator-facilitated PrEP referral process from a sexual health center (SHC) to a co-located PrEP clinic as an alternative delivery model. Electronic health record (EHR) data were used to calculate the number of clients seen at the SHC in 2019. Charts were manually reviewed to determine whether a PrEP clinic referral was made and document type of referral method: face-to-face appointment scheduling with the navigator (warm handoff), EHR messaging to navigator to schedule the appointment at a later time (EHR message), or provision of navigator's contact information to the client (card only). In 2019, 2481 unique potentially PrEP-eligible clients were seen at the SHC; 220 (9%) received a PrEP referral. Of referred clients, median age was 30 years (interquartile range, 24–34), 182 (83%) were male, 89 (40%) were non-Hispanic Black, and 24 (11%) were Latinx. In total, 94/220 (43%) referred clients attended an initial PrEP visit with a provider, and the proportion attending by referral method was 81%, 36%, and 27% for warm handoff, EHR message, and card only, respectively (p< 0.0001). Despite co-location of these two clinics, there were significant drop-offs along the PrEP care continuum for this referral system. Warm handoff was the most effective referral method, but further efforts are needed to understand barriers to referral. Implementation of same-day PrEP services at SHCs is one potential solution to engaging additional clients.