权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Equitable coverage for HIV-Pre-Exposure Prophylaxis and optimization of HIV Prevention programme delivery

艾滋病毒暴露前预防的公平覆盖和艾滋病毒预防计划实施的优化

基本信息

批准号：
2074213
负责人：
金额：
--
依托单位：
University College London
依托单位国家：
英国
项目类别：
Studentship
财政年份：
2018
资助国家：
英国
起止时间：
2018 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=studentship-2074213
关键词：
Equitable coverage HIV Pre Exposure

项目摘要

Background Oral HIV Pre-Exposure prophylaxis (PrEP) is a highly effective biomedical intervention for reducing HIV acquisition, and is recommended by the WHO as part of a comprehensive approach to HIV prevention1. In England, PrEP can be acquired through a number of different routes, including: 1) A private prescription from a doctor (cost to patient is £400 per month; 2) private online providers (cost to patient is £35-£45 a month); 3) an ongoing implementation trial (the PrEP Impact Trial), funded by NHS England (no cost to patient). The PrEP Impact Trial will run until October 2020 in sexual health clinics and will collect biomedical outcome data (i.e., the proportion of clinic attendees meeting PrEP eligibility criteria, proportion prescribed PrEP, duration of their eligibility; HIV/STI diagnoses; adverse events). However, only data on trial participants will be collected; questions remain regarding eligibility among people who do not attend sexual health clinics, and the attitudes of the wider community.PrEP provision programmes have been implemented in many locations worldwide, however, there have been reports of low uptake among certain populations, including young men who have sex with men (MSM) 2,3 and heterosexual men and women2. Furthermore, despite a fall in the rate of new HIV diagnoses in England, not all groups, for example heterosexual men and women, have seen sustained or equal rates of decline4. These populations may benefit from interventions to increase PrEP awareness, uptake, and adherence. In order to identify which populations are most at need of interventions, requires both an estimation of the at risk population eligible for PrEP, and the uptake within that population. The population of MSM in England who are eligible for PrEP has been estimated5, however, other risk groups, including black and minority ethnic heterosexual men and women, are less well characterised.There is currently no standardised measure to evaluate uptake, coverage and need in at-risk populations. Such a measure could be used to evaluate current and future PrEP implementation programmes, and identify groups that could benefit from additional interventions to increase uptake and support PrEP adherence. Overall AimThe aim of this work is to develop a measure of equitable PrEP coverage for populations at high risk of HIV in England, and explore the barriers and facilitators to PrEP access, uptake and adherence.

背景口服HIV暴露前预防(PrEP)是一种减少HIV感染的高效生物医学干预措施，世界卫生组织建议将其作为HIV预防综合方法的一部分1。在英格兰，PrEP可以通过许多不同的途径获得，包括：1)从医生那里获得私人处方(向患者支付的费用为每月400 GB)；2)私人在线提供商(向患者支付的费用为每月35-45 GB)；3)正在进行的实施试验(PrEP Impact试验)，由NHS England资助(对患者免费)。PrEP Impact试验将在性健康诊所持续到2020年10月，并将收集生物医学结果数据(即，符合PrEP资格标准的诊所就诊者比例、开出PrEP的比例、他们合格的持续时间；艾滋病毒/性传播感染诊断；不良事件)。然而，将只收集试验参与者的数据；关于没有就诊性健康诊所的人的资格以及广大社区的态度仍然存在问题。世界各地已在许多地方实施了初级保健方案，但有报告称，某些人群的接种率较低，包括男男性行为者2、3和异性恋男女2。此外，尽管英格兰的艾滋病毒新诊断率有所下降，但并非所有群体，例如异性恋男性和女性，都出现了持续或同等的下降4。这些人群可能受益于提高PrEP意识、摄取率和依从性的干预措施。为了确定哪些人群最需要干预，既需要估计有资格接受预防接种的高危人群，也需要估计该人群的吸毒率。据估计，英格兰有资格接受预防接种计划的男男性接触者人数5，然而，其他风险群体，包括黑人和少数族裔异性恋男性和女性，则没有那么好的特征。目前还没有标准化的衡量标准来评估高危人群的吸收、覆盖率和需求。这一衡量标准可用于评估当前和未来的PrEP实施方案，并确定可受益于额外干预措施的群体，以增加对PrEP的接受和支持PrEP的遵守。总体目标这项工作的目的是为英格兰艾滋病毒高危人群制定公平的预防接种计划覆盖率的措施，并探索预防接种计划获得、吸收和遵守的障碍和促进者。