Division of HIV/AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
Medicine (Baltimore). 2021 Oct 29;100(43):e27563. doi: 10.1097/MD.0000000000027563.
Non-occupational post-exposure prophylaxis (nPEP) has often relied on the joint work of emergency physicians and infectious disease specialists in busy emergency departments and human immunodeficiency virus (HIV)/sexually transmitted infections clinics abroad, where adherence education and follow-up are invariably reactive. In our pilot study, community-based organizations (CBOs) were invited to together implement the nPEP tailored to men who have sex with men (MSM) in 2 cities of Guangxi in Southwestern China, of which experiences and lessons drawn from would be provided to the promotion of nPEP in China.The study population enrolled MSM individuals prescribed nPEP from September 2017 to December 2019. One-to-one follow-ups by CBOs were applied through the treatment. Predictors of treatment completion were assessed by logistic regression.Of 271 individuals presented for nPEP, 266 MSM with documented treatment completion or non-completion, 93.6% completed the 28-day course of medication. Completion was associated with reporting side effects (aOR = .10; 95% CI: 0.02-0.38; P = .001). The follow-up rate of 91.9% was achieved based on the definition of loss to follow-up. No documented nPEP failures were found, although 1 MSM subsequently seroconverted to HIV due to ongoing high-risk behavior.CBOs' engagement in HIV nPEP, especially the "one-to-one" follow-up supports by peer educators partly ensure adherence and retention to nPEP. Tailored interventions are needed to address the subsequent high-risk behaviors among the MSM population.
非职业性暴露后预防(nPEP)通常依赖于急诊医师和传染病专家在繁忙的急诊部门和国外的人类免疫缺陷病毒(HIV)/性传播感染诊所的共同努力,在这些地方,坚持教育和随访始终是被动的。在我们的试点研究中,邀请了社区组织(CBO)共同实施针对中国广西两个城市男男性行为者(MSM)的 nPEP,从中吸取的经验教训将为在中国推广 nPEP 提供参考。该研究纳入了 2017 年 9 月至 2019 年 12 月期间接受 nPEP 治疗的 MSM 个体。通过治疗应用 CBO 进行一对一随访。通过逻辑回归评估治疗完成的预测因素。在 271 名接受 nPEP 治疗的个体中,有 266 名 MSM 记录了完成或未完成治疗,93.6%的人完成了 28 天的疗程。完成治疗与报告副作用有关(aOR=0.10;95%CI:0.02-0.38;P=0.001)。根据失访定义,随访率达到 91.9%。虽然有 1 名 MSM 由于持续的高风险行为而随后 HIV 血清转换,但没有发现 nPEP 失败的记录。CBO 参与 HIV nPEP,特别是同伴教育者提供的“一对一”随访,部分确保了 nPEP 的坚持和保留。需要有针对性的干预措施来解决 MSM 人群中的后续高风险行为。