Nunn Amy S, Brinkley-Rubinstein Lauren, Oldenburg Catherine E, Mayer Kenneth H, Mimiaga Matthew, Patel Rupa, Chan Philip A
aDepartment of Behavioral and Social Sciences, School of Public Health, Brown University bThe Warren Alpert Medical School, Brown University cDivision of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island dDepartment of Social Medicine eCenter for Health Equity Research, University of North Carolina, Chapel Hill, North Carolina fFrancis I. Proctor Foundation, University of California, San Francisco gThe Fenway Institute hThe Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts iThe Division of Infectious Disease, School of Medicine, Washington University, Washington.
AIDS. 2017 Mar 13;31(5):731-734. doi: 10.1097/QAD.0000000000001385.
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. There is little scientific consensus about how to measure PrEP program implementation progress. We draw on several years of experience in implementing PrEP programs and propose a PrEP continuum of care that includes: (1) identifying individuals at highest risk for contracting HIV, (2) increasing HIV risk awareness among those individuals, (3) enhancing PrEP awareness, (4) facilitating PrEP access, (5) linking to PrEP care, (6) prescribing PrEP, (7) initiating PrEP, (8) adhering to PrEP, and (9) retaining individuals in PrEP care. We also propose four distinct categories of PrEP retention in care that include being: (1) indicated for PrEP and retained in PrEP care, (2) indicated for PrEP and not retained in PrEP care, (3) no longer indicated for PrEP, and (4) lost to follow-up for PrEP care. This continuum of PrEP care creates a framework that researchers and practitioners can use to measure PrEP awareness, uptake, adherence, and retention. Understanding each point along the proposed continuum of PrEP care is critical for developing effective PrEP interventions and for measuring public health progress in PrEP program implementation.
暴露前预防（PrEP）是一种有效的艾滋病预防策略。关于如何衡量PrEP项目的实施进展，目前几乎没有科学共识。我们借鉴了多年实施PrEP项目的经验，提出了一个PrEP连续照护模式，包括：（1）识别感染艾滋病病毒风险最高的个体；（2）提高这些个体对艾滋病病毒风险的认识；（3）增强对PrEP的认识；（4）促进PrEP的可及性；（5）与PrEP护理建立联系；（6）开具PrEP处方；（7）启动PrEP；（8）坚持PrEP治疗；（9）使个体持续接受PrEP护理。我们还提出了PrEP护理持续接受的四个不同类别，包括：（1）符合PrEP指征并持续接受PrEP护理；（2）符合PrEP指征但未持续接受PrEP护理；（3）不再符合PrEP指征；（4）失访PrEP护理。这种PrEP连续照护模式创建了一个框架，研究人员和从业者可以用来衡量PrEP的知晓率、使用率、依从性和持续接受率。了解PrEP连续照护模式中的每一点对于制定有效的PrEP干预措施以及衡量PrEP项目实施中的公共卫生进展至关重要。
