利用实施科学框架界定高负担环境中为孕妇和产后妇女提供暴露前预防措施方面的差距。
Defining gaps in pre-exposure prophylaxis delivery for pregnant and post-partum women in high-burden settings using an implementation science framework.
机构信息
Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA.
Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
出版信息
Lancet HIV. 2020 Aug;7(8):e582-e592. doi: 10.1016/S2352-3018(20)30102-8.
Abstract
Pregnancy is a high-risk period for HIV acquisition in African women, and pregnant women who become acutely infected with HIV account for up to a third of vertical HIV transmission cases in African settings. To protect women and eliminate vertical transmission, WHO recommends offering oral pre-exposure prophylaxis (PrEP) based on tenofovir to HIV-negative pregnant and post-partum women with a substantial risk of HIV acquisition. PrEP implementation for pregnant and post-partum women lags behind implementation for other high-risk populations. Unique considerations for PrEP implementation arise during pregnancy and post partum, including the integration of provider training with clinical delivery and monitoring of PrEP exposure and outcomes within existing maternal health systems, yet scarce implementation data are available to generate evidence in this context.
摘要
怀孕是非洲妇女感染艾滋病毒的高危时期，在非洲环境中，急性感染艾滋病毒的孕妇占垂直艾滋病毒传播病例的三分之一。为了保护妇女并消除垂直传播，世卫组织建议向艾滋病毒阴性的有大量艾滋病毒感染风险的孕妇和产后妇女提供基于替诺福韦的口服暴露前预防（PrEP）。为孕妇和产后妇女实施 PrEP 的工作落后于为其他高危人群实施 PrEP 的工作。在怀孕和产后期间实施 PrEP 时需要考虑一些独特的因素，包括将提供者培训与临床服务相结合，以及在现有妇幼保健系统中监测 PrEP 的暴露和结果，但在这方面可提供的实施数据很少，无法提供相关证据。
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