Spector Anya Y, Remien Robert H, Tross Susan
HIV Center for Clinical and Behavioral Studies, Columbia University and NY State Psychiatric Institute, 722 West 168th Street, New York 10032, NY, USA.
Subst Abuse Treat Prev Policy. 2015 Jan 8;10:1. doi: 10.1186/1747-597X-10-1.
To examine substance abuse treatment providers' views on engaging clients in Pre-exposure Prophylaxis (PrEP) care and research trials.
Thirty-six medical and counseling service providers in six New York City outpatient substance abuse treatment programs participated in semi-structured qualitative interviews. Thematic content analysis was conducted by three coders, independently.
Providers' perspectives toward PrEP were characterized by six salient themes: 1) Limited PrEP awareness. 2) Ambivalence about PrEP; 3) Perception of multiple challenges to delivery; 4) Uncertainty about clients' ability to be adherent to medication; 5) Concerns about medication safety/side effects; and 6) Perception of multiple barriers to conducting clinical trials.
Despite anticipated challenges, providers supported the introduction of PrEP in outpatient substance abuse treatment. Comprehensive training for providers is needed and should include PrEP eligibility criteria, strategies to support adherence and medication monitoring guidelines. Linkages between substance abuse treatment and primary care and/or enhancement of capacity within clinics to offer PrEP may help facilitate PrEP delivery. When conducting research in outpatient clinics, it is particularly important to protect client confidentiality.
探讨药物滥用治疗提供者对于让服务对象参与暴露前预防（PrEP）护理及研究试验的看法。
纽约市六个门诊药物滥用治疗项目中的36名医疗及咨询服务提供者参与了半结构化定性访谈。由三名编码员独立进行主题内容分析。
提供者对PrEP的看法有六个显著主题：1）对PrEP的认知有限；2）对PrEP矛盾的态度；3）对实施PrEP存在多种挑战的认知；4）对服务对象坚持服药能力的不确定性；5）对药物安全性/副作用的担忧；6）对开展临床试验存在多种障碍的认知。
尽管存在预期的挑战，但提供者支持在门诊药物滥用治疗中引入PrEP。需要为提供者提供全面培训，培训应包括PrEP资格标准、支持坚持服药的策略以及药物监测指南。药物滥用治疗与初级保健之间的联系和/或诊所内提供PrEP能力的增强可能有助于PrEP的实施。在门诊诊所进行研究时，保护服务对象的隐私尤为重要。
