Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX.
Department of Pediatrics, Maimonides Medical Center, Brooklyn, NY.
J Acquir Immune Defic Syndr. 2018 Apr 1;77(4):365-372. doi: 10.1097/QAI.0000000000001605.
Publicly funded HIV-testing sites can identify HIV preexposure prophylaxis (PrEP) candidates and provide PrEP linkage.
Harris Health System's HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city.
A prospective assessment of individuals aged 18 years and older recruited from walk-in HIV testing from December 2013 to April 2015 included risk assessment, HIV testing, and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review.
The mean age of our sample (n = 300) was 38.3 ± 11.7 years. Men constituted 63.1% of the sample and 53.7% were black non-Hispanic, 26.3% Hispanic, and 14.7% white non-Hispanic. Most were uninsured (63.5%). Only 27% always used condoms, although 67% perceived personal HIV risk. Of 300 participants, 64 (21.3%) linked to PrEP care and 49 (16.3%) took PrEP. In multivariable analysis, compared with heterosexual men, women [adjusted OR (aOR) 4.1, 95% CI: 1.5 to 11.1] and MSM (aOR 10.2, 95% CI: 3.4 to 31.0) were more likely to attend HPP and to take PrEP (aOR 3.0, 95% CI: 1.6 to 15.1 and 3.0, 95% CI: 1.1 to 8.3, respectively). Serodiscordance and PrEP interest correlated with program attendance (aOR 14.0, 95% CI: 6.1 to 32.3 and aOR 6.7, 95% CI: 1.8 to 25.4) and taking PrEP (aOR 13.1, 95% CI: 5.2 to 32.8 and 14.4, 95% CI: 1.8 to 166.9), respectively.
Preexposure prophylaxis interest, being female or MSM, and serodiscordance correlated with PrEP linkage. Safety-net health systems can facilitate PrEP access in marginalized populations, but the PrEP initiation rates remain low.
公共资金资助的艾滋病毒检测点可以发现艾滋病毒暴露前预防（PrEP）候选者，并提供 PrEP 衔接服务。
德克萨斯州休斯顿哈里斯卫生系统的艾滋病毒诊所、艾滋病毒检测计划和艾滋病毒预防计划（HPP），这是一个艾滋病毒发病率较高的城市。
对 2013 年 12 月至 2015 年 4 月间从现场艾滋病毒检测中招募的年龄在 18 岁及以上的个体进行前瞻性评估，包括风险评估、艾滋病毒检测和自我管理调查，并在 6 个月和 12 个月进行随访调查和医疗记录审查。
我们样本（n=300）的平均年龄为 38.3±11.7 岁。男性占样本的 63.1%，53.7%为黑人非西班牙裔，26.3%为西班牙裔，14.7%为白种非西班牙裔。大多数人没有保险（63.5%）。尽管 67%的人认为自己有感染艾滋病毒的个人风险，但只有 27%的人始终使用安全套。在 300 名参与者中，64 人（21.3%）与 PrEP 护理机构建立了联系，49 人（16.3%）接受了 PrEP。在多变量分析中，与异性恋男性相比，女性[调整后的比值比（aOR）4.1，95%置信区间：1.5 至 11.1]和男男性行为者（aOR 10.2，95%置信区间：3.4 至 31.0）更有可能参加 HPP 并服用 PrEP[aOR 3.0，95%置信区间：1.6 至 15.1 和 3.0，95%置信区间：1.1 至 8.3]。血清不一致和 PrEP 兴趣与项目参与度相关（aOR 14.0，95%置信区间：6.1 至 32.3 和 aOR 6.7，95%置信区间：1.8 至 25.4）和服用 PrEP（aOR 13.1，95%置信区间：5.2 至 32.8 和 14.4，95%置信区间：1.8 至 166.9）。
PrEP 兴趣、女性或男男性行为者以及血清不一致与 PrEP 衔接相关。安全网卫生系统可以促进边缘化人群获得 PrEP，但 PrEP 的起始率仍然很低。
