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谁发起对话,谁接受暴露前预防(PrEP)?医疗服务提供者 PrEP 实践的简要在线调查。

Who Starts the Conversation and Who Receives Preexposure Prophylaxis (PrEP)? A Brief Online Survey of Medical Providers' PrEP Practices.

机构信息

1 George Mason University, Fairfax, VA, USA.

2 Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.

出版信息

Health Educ Behav. 2018 Oct;45(5):723-729. doi: 10.1177/1090198117752789. Epub 2018 Jan 20.

Abstract

Uptake of preexposure prophylaxis (PrEP) has been slow, but is increasing. Although PrEP is indicated for many patients, it has been concentrated among men who have sex with men (MSM). Awareness of PrEP is limited among non-MSM individuals, and among some MSM. As such, individuals at risk for HIV who are unaware of PrEP must rely on their medical providers to initiate conversations about PrEP. Members of a national professional organization of HIV specialists with prescribing privileges, including physicians, nurse practitioners, and physician assistants, participated in an online survey ( n = 342) to characterize their PrEP prescribing behaviors and the demographic membership of their PrEP patients. Results indicated that when discussing PrEP with their patients, providers who more frequently initiated these conversations had a higher percentage of non-MSM patients in their PrEP caseload (e.g., women, people who inject drugs, transgender patients). Encouraging providers to initiate discussions about PrEP with their patients and helping them locate support to offset the cost may help increase uptake, particularly among at-risk patients who are underrepresented in PrEP adoption.

摘要

暴露前预防(PrEP)的使用率一直很低,但正在上升。尽管 PrEP 适用于许多患者,但它主要集中在与男性发生性关系的男性(MSM)中。非 MSM 人群以及一些 MSM 人群对 PrEP 的认识有限。因此,那些不知道 PrEP 的有感染 HIV 风险的个人必须依赖他们的医疗服务提供者来启动关于 PrEP 的对话。具有处方特权的全国性艾滋病毒专家专业组织的成员,包括医生、护士从业者和医师助理,参与了一项在线调查(n=342),以描述他们的 PrEP 处方行为以及他们的 PrEP 患者的人口统计学特征。结果表明,在与患者讨论 PrEP 时,更频繁地发起这些对话的提供者在他们的 PrEP 患者中,非 MSM 患者的比例更高(例如,女性、注射毒品者、跨性别者)。鼓励提供者与患者讨论 PrEP,并帮助他们找到支持以抵消费用,这可能有助于提高使用率,特别是在 PrEP 使用率较低的有感染 HIV 风险的患者中。

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