Caponi Mitchell, Burgess Carolyne, Leatherwood Alexandra, Molano Luis Freddy
Community Healthcare Network, New York, NY, United States of America.
New York University, New York, NY, United States of America.
Prev Med Rep. 2019 May 14;15:100889. doi: 10.1016/j.pmedr.2019.100889. eCollection 2019 Sep.
Individuals who are at high risk of contracting HIV should have equitable access to preventive measures, such as pre-exposure prophylaxis (PrEP). We conducted a retrospective data extract from the electronic medical records of federally-qualified health centers in New York City from 2016 to 2018. Descriptive statistics are presented, stratified by those who have been prescribed PrEP and those who have not. We created a variable called "ever-female" which includes individuals assigned female at birth or who have ever identified as female. A chi-square test was performed to determine the statistical significance between variables as p < .05. A total of 9659 patients met inclusion criteria for the study. Patients who were prescribed PrEP were significantly associated with being white and never-female, with 38.2% of those prescribed PrEP identifying as white and 83.8% of those prescribed PrEP categorized as never-female. Patients of trans experience were 9.6% of the PrEP cohort and 1.5% of the never PrEP cohort (p < .001). Patients identifying as Black/African American made up 19.8% of patients prescribed PrEP and 49.8% of those never prescribed PrEP (p < .001). Patients with the lowest reported income composed 48.4% of those prescribed PrEP compared to 69.3% of patients who were never prescribed PrEP (p < .001). These findings indicate that key demographic categories may not be accessing PrEP as much as would be expected for their level of risk. Barriers to access of PrEP for women and other at-risk, under-represented populations should be further studied.
感染艾滋病毒风险较高的个体应能公平地获得预防措施，如暴露前预防（PrEP）。我们对纽约市2016年至2018年联邦合格健康中心的电子病历进行了回顾性数据提取。给出了描述性统计数据，按是否开具PrEP进行分层。我们创建了一个名为“曾经为女性”的变量，包括出生时被指定为女性或曾自认为女性的个体。进行卡方检验以确定变量之间的统计学显著性，p<0.05。共有9659名患者符合该研究的纳入标准。开具PrEP的患者与白人及从未为女性显著相关，开具PrEP的患者中有38.2%为白人，开具PrEP的患者中有83.8%被归类为从未为女性。有跨性别经历的患者在PrEP队列中占9.6%，在未使用PrEP队列中占1.5%（p<0.001）。自认为是黑人/非裔美国人的患者在开具PrEP的患者中占19.8%，在未开具PrEP的患者中占49.8%（p<0.001）。报告收入最低的患者在开具PrEP的患者中占48.4%，而在从未开具PrEP的患者中占69.3%（p<0.001）。这些发现表明，关键人口类别可能没有按照其风险水平预期的那样充分获得PrEP。应进一步研究女性和其他高危、代表性不足人群获得PrEP的障碍。
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