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两种增加人类免疫缺陷病毒伙伴服务项目范围和活动的模式:快速通道项目的初步发现。

Two Models for Increasing the Scope and Activities of Human Immunodeficiency Virus Partner Services Programs: Preliminary Findings From the Fast Track Project.

机构信息

From the Department of Psychology, Hunter College of the City University of New York.

New York City Department of Health and Mental Hygiene, New York City, NY.

出版信息

Sex Transm Dis. 2023 Aug 1;50(8S Suppl 1):S57-S63. doi: 10.1097/OLQ.0000000000001776. Epub 2023 Jan 25.

Abstract

BACKGROUND

We sought to develop a novel strategy for expanding an existing human immunodeficiency virus (HIV) partner services (PS) model to provide comprehensive sexual health services, including sexually transmitted infection testing, a virtual telemedicine visit, and access to immediate start medication (antiretroviral treatment, preexposure or postexposure prophylaxis). Fast Track was a National Institutes of Health-funded implementation science trial in New York City to pilot and refine the new strategy, and examine its feasibility, acceptability, and impact.

METHODS

Over the course of 1 year, health department staff collaborated with the academic research team to develop Fast Track protocols and workflows, create a cloud-based database to interview and track patients, and train disease intervention specialists to deliver the new program. The initial field-based program (Fast Track 1.0) was piloted March to December 2019. A modified telephone-based program (Fast Track 2.0) was developed in response to COVID-19 pandemic constraints and was piloted August 2020 to March 2021.

RESULTS

These 2 pilots demonstrate the feasibility and acceptability of integrating comprehensive sexual health services into HIV PS programs. Disease intervention specialists were successfully trained to conduct comprehensive sexual health visits, and clients reported that the availability of comprehensive sexual health services made them more willing to engage with PS. Key lessons for scale-up include managing collaboration with a licensed provider, navigating technical and technological issues, and challenges in client engagement and retention.

CONCLUSIONS

The success of this integrated strategy suggests that telehealth visits may be a critical gateway to care engagement for PS clients. This model is an innovative strategy for increasing engagement with HIV testing, prevention, and treatment for underserved populations.

摘要

背景

我们旨在开发一种新策略,以扩大现有的人类免疫缺陷病毒(HIV)伙伴服务(PS)模式,提供全面的性健康服务,包括性传播感染检测、虚拟远程医疗访问以及获得即时起始药物(抗逆转录病毒治疗、暴露前或暴露后预防)。Fast Track 是一项由美国国立卫生研究院资助的实施科学试验,在纽约市试点和完善新策略,并检验其可行性、可接受性和影响。

方法

在 1 年的时间里,卫生部门工作人员与学术研究团队合作制定了 Fast Track 方案和工作流程,创建了一个基于云的数据库来采访和跟踪患者,并培训疾病干预专家来提供新方案。初始的基于现场的方案(Fast Track 1.0)于 2019 年 3 月至 12 月试点。为应对 COVID-19 大流行的限制,开发了一种改良的电话方案(Fast Track 2.0),并于 2020 年 8 月至 2021 年 3 月试点。

结果

这两个试点表明,将全面性健康服务纳入 HIV PS 方案是可行和可接受的。疾病干预专家成功地接受了全面性健康访问的培训,客户报告说,全面性健康服务的提供使他们更愿意接受 PS。扩大规模的关键经验教训包括管理与持照提供者的合作、解决技术和技术问题,以及在客户参与和保留方面的挑战。

结论

这种综合策略的成功表明,远程医疗访问可能是 PS 客户参与护理的关键门户。该模型是一种创新策略,可提高对服务不足人群的 HIV 检测、预防和治疗的参与度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62d0/10348611/0e8d31f75a8d/std-50-s57-g001.jpg

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