Sex Transm Dis. 2018 Jan;45(1):50-55. doi: 10.1097/OLQ.0000000000000690.
Human immunodeficiency virus preexposure prophylaxis (PrEP) uptake remains low in high-risk populations. Sexually transmitted infection (STI) clinics reach PrEP-eligible persons and may be ideal settings to model PrEP implementation.
Consenting PrEP-eligible patients identified at Chicago Department of Public Health STI Clinics were actively referred to PrEP partner sites between June 1, 2015, and May 31, 2016. Outcomes included successful contact by a partner site, linkage to a partner site, and receipt of a PrEP prescription. Bivariable and time to event analyses were conducted to determine significant associations of outcomes.
One hundred thirty-seven patients were referred; 126 (92%) were men who have sex with men, and mean age was 29 years. Ninety-eight (72%) were contacted by a PrEP partner, 43 (31%) were linked, and 40 (29%) received a prescription. Individuals aged 25 years and older were more likely to link (odds ratio, 3.10; 95% confidence interval, 1.30-7.41) and receive a PrEP prescription (odds ratio, 2.70; 95% confidence interval, 1.12-6.45) compared with individuals 24 years and younger. The average time between each step was greater for those 24 years and younger compared with those aged 25 years and older for all steps. Time to event analyses revealed that those aged 25 years and older were significantly more likely to receive a prescription compared to those aged 24 years and younger (hazard ratio, 3.62; 95% risk limits, 1.47-8.92).
Preexposure prophylaxis active referrals from STI clinics to partner sites are feasible, though drop out was prominent in the initial steps of the continuum. Youth were less likely to link or receive prescriptions, indicating the need for tailored interventions for this vulnerable population.
在高危人群中，人类免疫缺陷病毒（HIV）暴露前预防（PrEP）的使用率仍然很低。性传播感染（STI）诊所可以接触到符合 PrEP 条件的人，并且可能是模拟 PrEP 实施的理想场所。
2015 年 6 月 1 日至 2016 年 5 月 31 日期间，在芝加哥公共卫生部门 STI 诊所主动将符合 PrEP 条件的患者转诊到 PrEP 合作伙伴机构。结果包括合作伙伴机构的成功联系、与合作伙伴机构的联系以及 PrEP 处方的接收。进行了单变量和时间事件分析，以确定结果的显著关联。
转诊了 137 名患者；126 名（92%）为男男性行为者，平均年龄为 29 岁。98 名（72%）被 PrEP 合作伙伴机构联系，43 名（31%）建立联系，40 名（29%）收到处方。25 岁及以上的个体更有可能建立联系（优势比，3.10；95%置信区间，1.30-7.41）并收到 PrEP 处方（优势比，2.70；95%置信区间，1.12-6.45）与 24 岁及以下个体相比。对于所有步骤，年龄在 24 岁及以下的个体在每个步骤之间的平均时间都大于年龄在 25 岁及以上的个体。时间事件分析表明，与 24 岁及以下的个体相比，25 岁及以上的个体更有可能收到处方（风险比，3.62；95%风险限制，1.47-8.92）。
从 STI 诊所主动向合作伙伴机构转诊 PrEP 是可行的，尽管在连续体的初始步骤中流失率很高。年轻人更不可能建立联系或接受处方，这表明需要为这一弱势群体制定有针对性的干预措施。
