Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
Family and Community Medicine, University of California San Francisco, San Francisco, California, USA.
Clin Infect Dis. 2022 Jul 6;74(12):2243-2248. doi: 10.1093/cid/ciab959.
Structural determinants of health drive inequities in the acquisition of human immunodeficiency virus (HIV) and the use of preexposure prophylaxis (PrEP) for HIV prevention among cisgender women in the United States. However, current PrEP clinical guidance and implementation paradigms largely focus on individual behaviors and characteristics, resulting in missed opportunities to improve PrEP access, and the implicit transferring of prevention work from health systems to individuals. In this viewpoint article, we outline ways to apply a structural lens to clinical guidance and PrEP implementation for women and propose areas for future work.
健康结构决定因素导致美国跨性别女性在获得人类免疫缺陷病毒（HIV）和使用暴露前预防（PrEP）进行 HIV 预防方面存在不平等。然而，目前的 PrEP 临床指导和实施模式主要侧重于个人行为和特征，从而错失了改善 PrEP 可及性的机会，并将预防工作从卫生系统转移到个人身上。在这篇观点文章中，我们概述了将结构视角应用于女性临床指导和 PrEP 实施的方法，并提出了未来工作的领域。
