Successful Implementation of HIV Preexposure Prophylaxis: Lessons Learned From Three Clinical Settings
Successful Implementation of HIV Preexposure Prophylaxis: Lessons Learned From Three Clinical Settings
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DOI：
10.1007/s11904-016-0308-x
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发表时间：
2016-04-01
影响因子：
4.6
通讯作者：
Cohen, Stephanie E.
中科院分区：
文献类型：
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作者：
Marcus, Julia L.;Volk, Jonathan E.;Cohen, Stephanie E.
在过去的3年里，我们已经从研究确定艾滋病毒暴露前预防（PrEP）的安全性和有效性过渡到了如何优化其实施的问题。直到最近，PrEP主要作为随机对照试验或开放标签研究的一部分提供。这些研究强调了PrEP提供的关键组成部分，包括定期检测艾滋病毒和其他性传播感染（STI），坚持和降低风险的支持，以及监测肾毒性。PrEP现在越来越多地在常规临床环境中提供。本综述总结了PrEP实施模式，从筛查到启动和随访，重点是三个交付系统的优势和劣势：健康维护组织，STI诊所和初级保健实践。这些早期实施经验表明，PrEP可以在各种环境中成功交付，并强调了在临床实践中简化PrEP交付的策略。
The past 3 years have marked a transition from research establishing the safety and efficacy of HIV preexposure prophylaxis (PrEP) to questions about how to optimize its implementation. Until recently, PrEP was primarily offered as part of randomized controlled trials or open-label studies. These studies highlighted the key components of PrEP delivery, including regular testing for HIV and other sexually transmitted infections (STIs), adherence and risk-reduction support, and monitoring for renal toxicity. PrEP is now increasingly provided in routine clinical settings. This review summarizes models for PrEP implementation from screening through initiation and follow-up, focusing on the strengths and weaknesses of three delivery systems: a health maintenance organization, an STI clinic, and a primary care practice. These early implementation experiences demonstrate that PrEP can be successfully delivered across a variety of settings and highlight strategies to streamline PrEP delivery in clinical practice.