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HIV 感染的暴露前预防(PrEP):一项评估 HIV 医护人员知识、态度和处方实践的调查结果。

Pre-exposure prophylaxis (PrEP) for HIV infection: results of a survey of HIV healthcare providers evaluating their knowledge, attitudes, and prescribing practices.

机构信息

1 Division of Infectious Disease, Department of Internal Medicine, Cedars Sinai Medical Center , Los Angeles, California.

出版信息

AIDS Patient Care STDS. 2013 Oct;27(10):553-9. doi: 10.1089/apc.2013.0173. Epub 2013 Sep 20.

Abstract

Antiretroviral medications can be taken by HIV-negative persons to prevent HIV infection, also known as pre-exposure prophylaxis (PrEP). PrEP was first shown to be effective during the iPrEX study. We conducted a survey involving HIV healthcare providers to document their attitudes and prescribing practices about PrEP in response to this study. An online survey was completed by 189 members and credentialees of the American Academy of HIV Medicine between April 2011 and September 2011. Ninety percent of respondents were familiar with the results of the iPrEx study, and most (78%) were familiar with CDC's interim guidance regarding the use of PrEP in MSM. Only 19% of respondents had prescribed PrEP. The majority of PrEP prescribers were compliant with CDC interim guidance; however, only 61% screened for hepatitis B. Of PrEP prescribers, 78% prescribed to MSM, 31% to MSW, and 28% to WSM. Greatest concerns about prescribing PrEP included development of antiretroviral resistance (32%), potential increase in high-risk behavior, (22%) and poor medication adherence (21%). Fifty-eight percent stated that HIV serodiscordance within a relationship most influenced their decision to prescribe PrEP to the HIV-seronegative partner. This study demonstrates that, despite awareness of the efficacy of PrEP, its use is limited. Survey participants used PrEP most commonly in MSM; however, a significant percentage also prescribed PrEP to women. The best candidate for PrEP is felt to be individuals in an HIV-serodiscordant relationship. Limitations to our study included a low response rate, changes in the evidence base, and the novelty of PrEP.

摘要

抗逆转录病毒药物可以被 HIV 阴性的人服用,以预防 HIV 感染,也称为暴露前预防(PrEP)。PrEP 在 iPrEX 研究中首次被证明是有效的。我们进行了一项涉及 HIV 医疗保健提供者的调查,以记录他们对 PrEP 的态度和处方实践,以回应这项研究。2011 年 4 月至 9 月期间,美国艾滋病医学学会的 189 名成员和认证人员完成了一项在线调查。90%的受访者熟悉 iPrEX 研究的结果,大多数(78%)熟悉 CDC 关于男男性行为者使用 PrEP 的临时指南。只有 19%的受访者开了 PrEP。大多数 PrEP 处方者都符合 CDC 的临时指南;然而,只有 61%的人筛查了乙型肝炎。在 PrEP 处方者中,78%的人开给男男性行为者,31%的人开给女性性工作者,28%的人开给变性女性。开 PrEP 的最大顾虑包括抗逆转录病毒耐药性的发展(32%)、高危行为的潜在增加(22%)和药物依从性差(21%)。58%的人表示,在性关系中 HIV 血清不一致最影响他们决定为 HIV 血清阴性的伴侣开 PrEP。这项研究表明,尽管人们意识到 PrEP 的疗效,但它的使用仍然有限。调查参与者最常将 PrEP 用于男男性行为者;然而,也有相当一部分人将 PrEP 开给女性。最适合 PrEP 的人被认为是 HIV 血清不一致的伴侣。我们研究的局限性包括响应率低、证据基础的变化和 PrEP 的新颖性。

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