医疗服务提供者以及对注射吸毒者中预防艾滋病毒的暴露前预防措施的减少伤害观点。
Medical Providers and Harm Reduction Views on Pre-Exposure Prophylaxis for HIV Prevention Among People Who Inject Drugs.
作者信息
Hershow Rebecca B, Gonzalez Michelle, Costenbader Elizabeth, Zule William, Golin Carol, Brinkley-Rubinstein Lauren
机构信息
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
University of California, San Francisco.
出版信息
AIDS Educ Prev. 2019 Aug;31(4):363-379. doi: 10.1521/aeap.2019.31.4.363.
Abstract
Despite high pre-exposure prophylaxis (PrEP) acceptability among people who inject drugs (PWID) and PrEP providers, PrEP uptake is low and little is known about how to promote PrEP among PWID. This qualitative study with providers in North Carolina explored views on PrEP delivery approaches for PWID. Interviewers conducted semistructured interviews with 10 PrEP providers and 10 harm reduction (HR) providers. Interviews were transcribed and analyzed. Many participants expressed acceptability for providing PrEP referrals at syringe exchange sites, stationing PrEP providers at syringe exchange sites to provide PrEP prescriptions, and providing standing orders for PrEP at syringe exchange sites. Barriers were identified, including low PrEP awareness and limited resources. Many advocated for co-location of HR and PrEP services and scaled-up outreach services. PrEP providers emphasized maintenance of clinical requirements, while HR providers emphasized flexibility when treating PWID. Promoting PrEP uptake and adherence among PWID likely requires integration of HR and PrEP services.
摘要
尽管在注射毒品者（PWID）和暴露前预防（PrEP）提供者中，PrEP的接受度较高，但PrEP的使用率较低，且对于如何在PWID中推广PrEP知之甚少。这项对北卡罗来纳州提供者开展的定性研究探讨了针对PWID的PrEP提供方式的观点。访谈者对10名PrEP提供者和10名减少伤害（HR）提供者进行了半结构化访谈。访谈内容被转录并进行了分析。许多参与者表示接受在注射器交换点提供PrEP转诊、在注射器交换点安排PrEP提供者以开具PrEP处方，以及在注射器交换点提供PrEP常备医嘱。研究发现了一些障碍，包括对PrEP的认知度低和资源有限。许多人主张将HR服务和PrEP服务合并，并扩大外展服务。PrEP提供者强调维持临床要求，而HR提供者则强调在治疗PWID时要有灵活性。在PWID中促进PrEP的使用和依从性可能需要整合HR服务和PrEP服务。
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Int J Drug Policy. 2017 Jul;45:33-39. doi: 10.1016/j.drugpo.2017.05.006. Epub 2017 Jun 1.
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