支付 PrEP 药物费用：影响美国人群使用暴露前预防措施的费用因素定性研究。
Paying for PrEP: A qualitative study of cost factors that impact pre-exposure prophylaxis uptake in the US.
机构信息
Department of Medicine, 12321Brown University, Providence, RI, USA.
Department of Health Policy and Management, Bloomberg School of Public Health, 25802Johns Hopkins University, Baltimore, MD, USA.
出版信息
Int J STD AIDS. 2022 Dec;33(14):1199-1205. doi: 10.1177/09564624221132406. Epub 2022 Oct 21.
BACKGROUND
Concerns about the actual and perceived costs of pre-exposure prophylaxis (PrEP) continue to be a major barrier to uptake among gay, bisexual and men who have sex with men (GBMSM) in the United States.
METHODS
We conducted semi-structured interviews with 25 GBMSM who presented for routine health care at a STD clinic in the northeastern United States. The cohort included GBMSM who were or were not currently taking PrEP and represented varied health care coverage and financial resources. We used a structured coding scheme to analyze transcripts and identify themes relevant to cost factors.
RESULTS
Participants shared their perspectives about PrEP and their experiences with accessing and paying for PrEP. Our findings suggest that health care coverage or financial assistance were essential to PrEP access but were not easily accessible to all people and did not always cover all costs. Therefore, paying for PrEP had to be balanced with other life expenses. Participants had multiple sources for information about PrEP cost and assistance from clinic and pharmacy staff helped reduce burden and resolve difficulties.
CONCLUSION
Addressing gaps in health care coverage, providing financial support, and improving the enrollment process in a financial assistance program may improve PrEP uptake.
背景
在美国，对暴露前预防（PrEP）实际和感知成本的担忧仍然是男同性恋、双性恋和男性性行为者（GBMSM）接受 PrEP 的主要障碍。
方法
我们对 25 名在东北部美国一家 STD 诊所接受常规医疗保健的 GBMSM 进行了半结构化访谈。该队列包括正在或未服用 PrEP 的 GBMSM，代表了不同的医疗保健覆盖范围和财务资源。我们使用结构化编码方案分析转录本并确定与成本因素相关的主题。
结果
参与者分享了他们对 PrEP 的看法以及他们获得和支付 PrEP 的经验。我们的研究结果表明，医疗保健覆盖或财务援助对于 PrEP 的获得至关重要，但并非所有人都容易获得，而且并不总是涵盖所有费用。因此，支付 PrEP 的费用必须与其他生活费用相平衡。参与者有多种获取 PrEP 费用信息的来源，诊所和药房工作人员的帮助减轻了负担并解决了困难。
结论
解决医疗保健覆盖范围的差距，提供财务支持，并改善财务援助计划的注册流程，可能会提高 PrEP 的使用率。
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