Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, LN6 7TS, Lincoln, UK.
Centre Population et Développement, UMR 196 Paris Descartes - IRD), SageSud (ERL INSERM 1244), Institut de Recherche pour le Développement, Paris, France.
AIDS Behav. 2022 Oct;26(10):3345-3355. doi: 10.1007/s10461-022-03646-0. Epub 2022 Apr 16.
Due to the high HIV incidence among the general population of Eswatini, pre-exposure prophylaxis (PrEP) for HIV-exposed individuals is recommended. However, little is known about PrEP uptake and preferences in PrEP delivery healthcare setting among the general population. We conducted a secondary analysis of a randomized trial that aimed to increase PrEP uptake. All clients eligible for PrEP in one of six public-sector healthcare facilities in Eswatini were included. PrEP uptake was stratified by initial reason for visit (e.g. outpatient). Preferences in PrEP delivery setting were collected among those clients who initiated PrEP. A total of 1782 clients had their HIV acquisition risk assessed. Of these, 72% (1277/1782) were considered at risk by healthcare providers and, among them, 40% (517/1277) initiated PrEP. Uptake was higher among clients visiting specifically to initiate PrEP (93%), followed by HIV testing visits (45.8%) and outpatient visits (40%). Among those who initiated PrEP, preferred delivery settings were outpatient services (31%), HIV testing services (26%), family planning (21%) and antenatal services (14%). Men or those at high risk of HIV acquisition were more likely to prefer HIV testing and outpatient services, while young women were more likely to visit and express a preference for antenatal and family planning services. Outpatient services and HIV testing services could be preferable choices for PrEP delivery integration, due to the high PrEP uptake and delivery setting preferences of the populations who use these services. Antenatal and family planning could also be considered with a view to targeting the youngest women.
由于斯威士兰普通人群中的艾滋病毒发病率较高，建议对艾滋病毒暴露者进行暴露前预防（PrEP）。然而，对于普通人群在 PrEP 提供医疗保健环境中 PrEP 的采用率和偏好知之甚少。我们对一项旨在提高 PrEP 采用率的随机试验进行了二次分析。所有有资格在斯威士兰六家公立医疗机构之一接受 PrEP 的客户都包括在内。根据最初就诊原因（例如门诊）对 PrEP 的采用率进行分层。在开始接受 PrEP 的客户中收集了 PrEP 提供设置的偏好。共有 1782 名客户评估了他们的 HIV 感染风险。其中，72%（1277/1782）被医疗服务提供者认为有感染风险，其中 40%（517/1277）开始接受 PrEP。专门为开始接受 PrEP 而就诊的客户的采用率较高（93%），其次是 HIV 检测就诊（45.8%）和门诊就诊（40%）。在开始接受 PrEP 的客户中，首选的提供设置是门诊服务（31%）、HIV 检测服务（26%）、计划生育（21%）和产前服务（14%）。男性或感染 HIV 风险较高的人更倾向于选择 HIV 检测和门诊服务，而年轻女性更倾向于就诊并表示愿意接受产前和计划生育服务。由于使用这些服务的人群 PrEP 采用率高且对提供设置的偏好，门诊服务和 HIV 检测服务可能是 PrEP 提供的首选选择。产前和计划生育也可以考虑，以便针对最年轻的女性。
