The prevalence of pre-exposure prophylaxis use and the pre-exposure prophylaxis-to-need ratio in the fourth quarter of 2017, United States
The prevalence of pre-exposure prophylaxis use and the pre-exposure prophylaxis-to-need ratio in the fourth quarter of 2017, United States
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DOI：
10.1016/j.annepidem.2018.06.005
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发表时间：
2018-12-01
影响因子：
5.6
通讯作者：
Sullivan, Patrick S.
中科院分区：
文献类型：
--
作者：
Siegler, Aaron J.;Mouhanna, Farah;Sullivan, Patrick S.
目的：在美国开始接受艾滋病毒暴露前预防（PrEP）治疗的人数尚未得到很好的描述，但自2012年以来一直在上升。这项分析评估的分布PrEP使用nationally and among subgroups.Methods：一个验证的算法量化替诺福韦酯富马酸二异丙酯/恩曲他滨在美国的PrEP应用于国家处方数据库，以确定季度患病率PrEP使用。自2016年以来的艾滋病毒诊断被用作PrEP需求的流行病学代理。PrEP需求比（PnR）定义为PrEP使用者人数除以新的HIV诊断结果。结果：2017年第四季度共有70，395人使用PrEP：67，166名男性和3229名女性。在全国范围内，PrEP使用的流行率为26/100，000（每100，000人的州范围[RAS/100 k]：4-73），PnR为1.8（RAS：0.5-6.6）。男性和女性的PrEP使用率分别为50/100，000和2/100，000（RAS/100 k：7-143和03-7），PnR为2.1和0.4（RAS：0.6-7.1和0.1-4.0）。在年龄小于或等于24岁和大于或等于55岁的个体中，PrEP使用率最低（15/100，000和6/100，000，RAS/100 k：1-45和0.4-14），PnR为0.9和1.5（RAS：0.2-5.6和0.3-7.0）。东北部的PnR最高（3.3）;南部最低（1.0）。与医疗补助扩张的国家有超过两倍的PnR比国家without expandment.Conclusions：现有数据表明，女性，年龄小于或等于24岁的个人和居民的南方有较低水平的PrEP使用相对于流行病的需要。这些结果是生态学的，错误的分类可能会削弱结果。PnR对今后评估艾滋病毒预防战略的采用是有用的。(C)2018作者爱思唯尔公司出版
Purpose: The number of individuals who have started a regimen for HIV pre-exposure prophylaxis (PrEP) in the United States is not well characterized but has been on the rise since 2012. This analysis assesses the distribution of PrEP use nationally and among subgroups.Methods: A validated algorithm quantifying tenofovir disoproxil fumarate/emtricitabine for PrEP in the United States was applied to a national prescription database to determine the quarterly prevalence of PrEP use. HIV diagnoses from 2016 were used as an epidemiological proxy for PrEP need. The PrEP-to-need ratio (PnR) was defined as the number of PrEP users divided by new HIV diagnoses.Results: A total of 70,395 individuals used PrEP in the fourth quarter of 2017: 67,166 males and 3229 females. Nationally, prevalence of PrEP use was 26/100,000 (range across states per 100,000 [RAS/100k]: 4-73) and the PnR was 1.8 (RAS: 0.5-6.6). Prevalence of PrEP use among males and females, respectively, was 50/100,000 and 2/100,000 (RAS/100k: 7-143 and 03-7) and PnR was 2.1 and 0.4 (RAS: 0.6-7.1 and 0.1-4.0). Prevalence of PrEP use was lowest among individuals aged less than or equal to 24 and more than or equal to 55 years (15/100,000 and 6/100,000, RAS/100k: 1-45 and 0.4-14), with PnR 0.9 and 1.5 (RAS: 0.2-5.6 and 0.3-7.0). The Northeast had the highest PnR (3.3); the South had the lowest (1.0). States with Medicaid expansion had more than double the PnR than states without expansion.Conclusions: Available data suggest that females, individuals aged less than or equal to 24 years and residents of the South had lower levels of PrEP use relative to epidemic need. These results are ecological, and misclassification may attenuate results. PnR is useful for future assessments of HIV prevention strategy uptake. (C) 2018 The Authors. Published by Elsevier Inc.