Ribeiro Sofia, Rocha Miguel
Department of International Health. Care and Public Health Research Institute (CAPHRI). Maastricht University. Maastricht. The Netherlands; Grupo de Ativistas em Tratamentos. Lisbon. Portugal.
CheckpointLX. Grupo de Ativistas em Tratamentos. Lisbon. Portugal.
Acta Med Port. 2019 Jun 28;32(6):441-447. doi: 10.20344/amp.11474.
Pre-exposure prophylaxis is defined as the use of antiretroviral drugs to prevent HIV acquisition in uninfected individuals. Recognizing the increasing use of informal pre-exposure prophylaxis in Portugal, CheckpointLX, a community clinic targeted to men who have sex with men in Lisbon, Portugal, began offering counselling and follow-up services prior to formal introduction. This study aims to characterize pre-exposure prophylaxis users attending CheckpointLX before formal pre-exposure prophylaxis introduction in Portugal, and those who were referred to pre-exposure prophylaxis in the National Health Service following formal approval of pre-exposure prophylaxis.
Data was collected by peer counsellors between May 2015 and September 2018 and inserted in a database. Medical care followed the European AIDS Clinical Society recommendations for pre-exposure prophylaxis eligibility, initiation and follow-up. For formal pre-exposure prophylaxis, the General-Directorate for Health's Pre-exposure Prophylaxis guidelines checklist was used.
Until the end of May 2018, CheckpointLX had a total of 90 appointments for wild pre-exposure prophylaxis, of which 64 (71%) were first time visits. As for the 380 service users referred to the National Health Service, most were Portuguese (n = 318, 84%), and the mean age was 31 (8.9) years old. Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria (n = 59, 83%).
Pre-exposure prophylaxis delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration, in the scope of broader preventive sexual health care.
Much remains to be done in Portugal to ensure that pre-exposure prophylaxis is available to those who need it the most. Offering pre-exposure prophylaxis at community clinics could be a first step.
暴露前预防被定义为使用抗逆转录病毒药物来预防未感染个体感染艾滋病毒。认识到葡萄牙对非正式暴露前预防的使用日益增加，位于葡萄牙里斯本、面向男男性行为者的社区诊所CheckpointLX在正式引入之前就开始提供咨询和后续服务。本研究旨在描述在葡萄牙正式引入暴露前预防之前到CheckpointLX就诊的暴露前预防使用者，以及在暴露前预防正式获批后被转介到国家卫生服务机构接受暴露前预防的使用者的特征。
2015年5月至2018年9月期间，同伴咨询师收集数据并录入数据库。医疗护理遵循欧洲艾滋病临床学会关于暴露前预防资格、启动和随访的建议。对于正式的暴露前预防，使用了卫生部的暴露前预防指南清单。
截至2018年5月底，CheckpointLX共有90次非正规暴露前预防预约，其中64次（71%）为首次就诊。至于被转介到国家卫生服务机构的380名服务使用者，大多数是葡萄牙人（n = 318，84%），平均年龄为31（8.9）岁。过去六个月与艾滋病毒感染状况不明的伴侣发生无保护性行为是最常见的资格标准（n = 59，83%）。
在更广泛的预防性性健康护理范围内，暴露前预防服务应辅以关于免疫重要性的有效信息以及关于更安全用药做法的教育。
在葡萄牙，要确保最需要的人能够获得暴露前预防，仍有许多工作要做。在社区诊所提供暴露前预防可能是第一步。
