HIV pre-exposure prophylaxis provision by U.S. health centers in 2021.
HIV pre-exposure prophylaxis provision by U.S. health centers in 2021.
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2021 年美国卫生中心提供 HIV 暴露前预防服务。
DOI：
10.1097/qad.0000000000003774
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Keuroghlian,AlexS
中科院分区：
文献类型：
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作者：
Chinbunchorn,Tanat;Mayer,KennethH;Campbell,Juwan;King,Dana;Krakower,Douglas;Marcus,JuliaL;Grasso,Chris;Keuroghlian,AlexS
目的：本研究的目的是评估美国卫生中心提供的艾滋病毒暴露前预防(PrEP)。设计：美国结束艾滋病毒流行(EHE)倡议将卫生中心指定为扩大PrEP规模的主要医疗系统。卫生中心为3000多万未参保、种族或民族分散的低收入患者提供初级保健。这项研究是第一次评估卫生中心的PrEP供应，包括诊所的特点、患者群体以及与PrEP处方相关的政策。方法：卫生资源和服务管理局的统一数据系统包含2021年1月1日至12月31日期间美国50个州、哥伦比亚特区和美国8个领地卫生中心PrEP处方和患者社会人口统计的汇总数据。我们比较了开与不开PrEP处方的卫生中心的患者人口统计学和医疗补助扩展和PrEP援助计划的可用性。结果：在1375个卫生中心服务30 193 278名患者中，79 163名患者开了PrEP处方。与没有开PrEP处方的卫生中心相比，开了PrEP处方的卫生中心有更高的性、性别、种族和少数民族患者人口比例。与不开PrEP处方的卫生中心相比，开出PrEP处方的卫生中心中，有更高比例的卫生中心位于EHE计划的指定高优先级司法管辖区，或拥有医疗补助扩大或公共PrEP援助计划的州。结论：在联邦和州一级政策的推动下，卫生中心对于扩大受艾滋病毒影响不成比例的小规模人群的PrEP至关重要。这些调查结果突出了服务差距，并为未来的干预措施提供了信息，以优化PrEP实施和支持EHE计划目标。
Objectives:The aim of this study was to assess HIV preexposure prophylaxis (PrEP) provision in US health centers.Design:The US Ending the HIV Epidemic (EHE) initiative designated health centers as the main healthcare system through which PrEP scale-up occurs. Health centers offer primary care to over 30 million disproportionately uninsured, racially or ethnically minoritized, and low-income patients. This study is the first to assess PrEP provision across health centers, including characteristics of clinics, patient populations, and policies associated with PrEP prescribing.Methods:The Health Resources and Services Administration's Uniform Data System contained aggregate data on PrEP prescriptions and patient sociodemographics at health centers from January 1 through December 31, 2021, in 50 US states, the District of Columbia, and eight US territories. We compared patient demographics and availability of Medicaid expansion and PrEP assistance programs at health centers that prescribed vs. those that did not prescribe PrEP.Results:Across 1375 health centers serving 30 193 278 patients, 79 163 patients were prescribed PrEP. Health centers that prescribed any PrEP had higher proportions of sexual, gender, racial, and ethnic minority patient populations compared with health centers that prescribed no PrEP. Compared with health centers that prescribed no PrEP, a higher proportion of health centers that prescribed PrEP were located in designated high-priority jurisdictions of the EHE initiative or states with Medicaid expansion or public PrEP assistance programs.Conclusion:Health centers are critical for scaling up PrEP in minoritized populations disproportionately affected by HIV, facilitated through federal and state-level policies. These findings highlight service gaps and inform future interventions to optimize PrEP implementation and support EHE initiative goals.