HIV providers' likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: a short report
HIV providers' likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: a short report
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DOI：
10.1080/09540121.2016.1153595
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发表时间：
2016-09-01
影响因子：
1.7
通讯作者：
Balderson, Benjamin H.
中科院分区：
文献类型：
--
作者：
Adams, Leah M.;Balderson, Benjamin H.
暴露前预防（PrEP）是一种针对艾滋病毒阴性高危人群的抗逆转录病毒治疗方案，已在多个患者人群的临床试验中证明了其疗效。疾病控制中心（CDC）发布了详细的指导方针，以帮助提供者为其高风险患者开具PrEP处方，包括男性同性恋者（MSM），高风险异性恋者和注射吸毒者（IDUs）。鉴于PrEP中的许多关注都集中在MSM患者身上，本研究使用在线调查来评估HIV护理提供者（n=363）关于处方PrEP的决定所涉及的因素，沿着他们愿意为来自各种风险人群的患者处方PrEP（例如，男男性接触者、异性恋者、注射吸毒者）。PrEP的有效性是供应商决定是否开具PrEP的重要因素，同时考虑患者对方案的依从性，定期随访护理和药物费用。这项调查的结果还表明，供应商的意愿，以规定PrEP不同的患者群体，与供应商最愿意启动方案与男男性行为者谁有艾滋病毒阳性的合作伙伴，最不愿意开处方给高风险的异性恋者或注射吸毒者。在目前疾病预防控制中心对PrEP（包括男男性行为者、异性恋者和注射吸毒者）的建议的背景下，研究提供者支持跨患者群体的艾滋病毒预防策略的理由和障碍值得进一步关注。
Pre-exposure prophylaxis (PrEP), the antiretroviral treatment regimen for HIV-negative people at high risk of acquiring HIV, has demonstrated efficacy across clinical trials in several patient populations. The Centers for Disease Control (CDC) have released detailed guidelines to aid providers in prescribing PrEP for their high-risk patients, including men who have sex with men (MSM), high-risk heterosexuals, and injection drug users (IDUs). Given that much attention in PrEP has focused on MSM patients, the present study used an online survey to assess factors involved in HIV care providers' (n=363) decisions about prescribing PrEP, along with their willingness to prescribe PrEP to patients from various risk populations (e.g., MSM, heterosexuals, IDUs). The efficacy of PrEP was an important factor in providers' decisions about prescribing PrEP, as were considerations about patients' adherence to the regimen, regular follow-up for care, and medication costs. This survey's findings also suggest that providers' willingness to prescribe PrEP varies by patient group, with providers most willing to initiate the regimen with MSM who have an HIV-positive partner, and least willing to prescribe to high-risk heterosexuals or IDUs. In the context of the current CDC recommendations for PrEP that include MSM, heterosexuals, and IDUs, examining providers' rationales for and barriers against supporting this HIV prevention strategy across patient groups merits further attention.