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在美国东南部一个综合医疗系统中,对艾滋病毒诊断情况以及与暴露前预防(PrEP)处方的关联进行调查。

Examining HIV Diagnosis and Linkage to PrEP Prescription Among Members at An Integrated Health System in the Southeast United States.

作者信息

Davis Teaniese L, Mittal Mona, Oragwu Adanna C, Wang Min Qi, Boekeloo Bradley O

机构信息

Center for Health Research, Kaiser Permanente Georgia, Atlanta, GA, USA.

Department of Family Science, University of Maryland School of Public Health, College Park, MD, USA.

出版信息

AIDS Behav. 2023 Mar;27(3):796-805. doi: 10.1007/s10461-022-03812-4. Epub 2022 Sep 12.

Abstract

Pre-Exposure Prophylaxis (PrEP) is a priority method for preventing HIV infection. This study's aims were threefold: (1) identify characteristics of members of a large health maintenance organization, Kaiser Permanente Georgia (KPGA), associated with HIV infection, (2) identify which member characteristics associated with HIV were also associated with PrEP prescription, and (3) identify which HIV-associated characteristics were associated with under- or over-prescribing of PrEP. Analysis of variables from the electronic medical record revealed that age, race, gender, mental health diagnosis, STI diagnosis, and sexual orientation were independently associated with HIV diagnosis. The same characteristics were independently associated with PrEP prescription except for race. Persons identifying as Black or unknown race, women, and/or heterosexual; and who had an STI diagnosis and/or illicit drug use had lower odds of being prescribed PrEP than of having an HIV diagnosis. The implications of these findings for improving physician identification of candidates for PrEP prescription are discussed.

摘要

暴露前预防(PrEP)是预防艾滋病毒感染的一种优先方法。本研究有三个目标:(1)确定与艾滋病毒感染相关的大型健康维护组织——佐治亚州凯撒永久医疗集团(KPGA)成员的特征;(2)确定与艾滋病毒相关的哪些成员特征也与PrEP处方相关;(3)确定与PrEP处方不足或过量相关的艾滋病毒相关特征。对电子病历中的变量进行分析后发现,年龄、种族、性别、心理健康诊断、性传播感染诊断和性取向与艾滋病毒诊断独立相关。除种族外,相同的特征与PrEP处方独立相关。自我认定为黑人或种族不明、女性和/或异性恋者;以及患有性传播感染诊断和/或使用非法药物的人,接受PrEP处方的几率低于被诊断为艾滋病毒感染的几率。本文讨论了这些发现对改善医生对PrEP处方候选人识别的意义。

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