Online Navigation for Pre-Exposure Prophylaxis via PleasePrEPMe Chat for HIV Prevention: Protocol for a Development and Use Study.
Online Navigation for Pre-Exposure Prophylaxis via PleasePrEPMe Chat for HIV Prevention: Protocol for a Development and Use Study.
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DOI：
10.2196/20187
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发表时间：
2020-09-22
影响因子：
1.7
通讯作者：
Tan J
中科院分区：
文献类型：
--
作者：
Weber S;Lazar L;McCord A;Romero C;Tan J
暴露前预防是一种艾滋病毒药物，由艾滋病毒阴性的个人在接触病毒之前服用，以防止感染。在不同社区的许多临床研究表明，如果按处方采取暴露前预防措施，则有很高的有效率。自2012年FDA(美国食品和药物管理局)批准第一种用于暴露前预防的产品以来，摄取量一直低于估计可从使用该产品受益的110万美国成年人，2017年估计有70,394人接受暴露前预防。其中，只有11%是黑人，13%是西班牙裔，尽管黑人和西班牙裔个人占到了可以受益的个人的三分之二，这突显了暴露前预防措施吸收方面的种族和民族差异。患者导航器已被证明在改善艾滋病毒携带者在艾滋病毒治疗级联过程中的联系和保持护理结果方面是有效的，并可在暴露前预防护理连续过程中使用，以协助决策并将潜在用户连接到暴露前预防服务。PleasePrEPMe Chat是一项新的在线战略，旨在通过免费的艾滋病毒预防信息和保健导航服务，提高加州符合暴露前预防条件的人群对暴露前预防保健服务的参与度。访问者通过在线双语(英语、西班牙语)聊天与导航员联系。在聊天期间，导航员通过PleasePrEPMe提供者目录帮助找到暴露前预防服务，提供艾滋病毒预防资源的链接，并支持未投保、投保和无证游客的福利导航。通过聊天日志和HealthEngage聊天平台收集数据，如日期、时间、相遇类型、访客类型、主要人口统计数据、讨论主题、保险和其他相关信息。从2017年4月到2019年12月，PleasePrEPMe完成了2191次在线聊天。平均互动时间为16分钟，68%的聊天内容涉及一个以上话题。讨论话题包括医疗导航(1104/2191，50.39%)、提供者识别(954/2191，43.54%)、暴露前预防信息(773/2191，35.28%)、暴露后预防信息(318/2191，14.91%)和加州暴露前预防援助计划(232/2191，10.59%)。对暴露前预防--或非暴露前预防--相关资源的转介包括目录更新、艾滋病毒检测和治疗、无法检测=无法传播、生殖健康、性传播感染和其他预防方法。共有368名聊天访问者完成了一份自愿满意度量表，对所提供服务的质量和帮助程度进行了评级，平均得分为4.7分(满分5分)。在线聊天是一种接触尚未从事艾滋病毒预防服务的人、支持艾滋病毒预防决策以及将在线寻求信息的人与面对面服务联系起来的一种方法。需要开展更多的研究，以评估线上性健康信息服务，并了解健康的社会决定因素如何影响在线参与，以便更好地了解如何接触到目前艾滋病毒预防服务没有得到很好服务的重点人群。RR1-10.2196/20187
Pre-exposure prophylaxis is an HIV medication taken by an individual who is HIV-negative to prevent infection before exposure to the virus. Numerous clinical studies in various communities have shown high rates of effectiveness when pre-exposure prophylaxis is taken as prescribed. Since FDA (US Food and Drug Administration) approval of the first product for pre-exposure prophylaxis in 2012, uptake has been lower than the estimated 1.1 million US adults who could benefit from its use, with an estimated 70,394 individuals on pre-exposure prophylaxis in 2017. Of these, only 11% were Black and 13% were Hispanic despite Black and Hispanic individuals comprising two-thirds of individuals who could benefit, highlighting racial and ethnic disparities in pre-exposure prophylaxis uptake. Patient navigators have been shown to be effective in improving the linkage and retention in care outcomes of people living with HIV across the HIV treatment cascade and can be used throughout the pre-exposure prophylaxis care continuum to assist decision making and connect potential users to pre-exposure prophylaxis services. PleasePrEPMe Chat was designed as a novel online strategy aimed at improving engagement in pre-exposure prophylaxis care services with pre-exposure prophylaxis–eligible populations in California via free HIV-prevention information and health care navigation services. Visitors connected with navigators via online bilingual (English, Spanish) chat. During the chat, navigators helped locate pre-exposure prophylaxis services through the PleasePrEPMe provider directory, provided links to HIV-prevention resources, and supported uninsured, insured, and undocumented visitors with benefits navigation. Data such as date, time, type of encounter, visitor type, key demographics, discussion topics, insurance, and other relevant information were collected via a chat log and through the HealthEngage chat platform. From April 2017 to December 2019, PleasePrEPMe completed 2191 online chats. Mean interaction time was 16 minutes, with 68% of chats covering more than one topic. Conversation topics included health care navigation (1104/2191, 50.39%), provider identification (954/2191, 43.54%), pre-exposure prophylaxis information (773/2191, 35.28%), post-exposure prophylaxis information (318/2191, 14.91%), and the California Pre-Exposure Prophylaxis Assistance Program (232/2191, 10.59%). Referrals to pre-exposure prophylaxis– or non pre-exposure prophylaxis–related resources included directory updates, HIV testing and treatment, undetectable=untransmittable, reproductive health, sexually transmitted infections, and other prevention methods. A total of 368 chat visitors completed a voluntary satisfaction scale rating the quality and helpfulness of the service provided, producing a mean rating of 4.7 out of 5. Online chat is a method for reaching people not already engaged in HIV-prevention services, supporting HIV-prevention decision making, and linking people seeking information online with in-person services. Additional research to evaluate online sexual health information services and understand how social determinants of health influence online engagement is needed to better understand how to reach priority populations not well served by current HIV-prevention services. RR1-10.2196/20187