Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA.
AIDS Behav. 2023 Aug;27(8):2731-2740. doi: 10.1007/s10461-023-03996-3. Epub 2023 Feb 4.
The COVID-19 pandemic interrupted health care delivery and exacerbated disparities. Many sexual health clinics transitioned to telemedicine, including for pre-exposure prophylaxis (PrEP). We conducted a retrospective cohort study of patients at an urban sexual health clinic to assess the likelihood and predictors of PrEP persistence in the year following PrEP initiation. We compared patients starting PrEP in the four months preceding the first COVID surge to those starting PrEP one year prior. We found lower PrEP persistence in the COVID cohort compared to the pre-COVID cohort (50.8% vs. 68.9%, respectively). In both cohorts, most care was provided through in-person visits and telemedicine was rare. In the pre-COVID cohort, older patients and those identifying as non-Hispanic White were more likely to persist on PrEP. In the COVID cohort, these disparities in PrEP persistence were not observed. Flexible models of care may facilitate equitable care engagement and re-engagement.
新冠疫情中断了医疗服务的提供，并加剧了不平等现象。许多性健康诊所转向远程医疗，包括暴露前预防（PrEP）。我们对一家城市性健康诊所的患者进行了回顾性队列研究，以评估在开始 PrEP 后的一年内 PrEP 持续使用的可能性和预测因素。我们将在首次新冠疫情激增前四个月开始 PrEP 的患者与一年前开始 PrEP 的患者进行了比较。我们发现，与新冠前疫情队列相比，新冠疫情队列中的 PrEP 持续使用情况较低（分别为 50.8%和 68.9%）。在两个队列中，大多数护理都是通过面对面的就诊提供的，远程医疗很少见。在新冠前疫情队列中，年龄较大的患者和非西班牙裔白人的患者更有可能持续使用 PrEP。而在新冠疫情队列中，没有观察到 PrEP 持续使用方面的这些差异。灵活的护理模式可能有助于公平地参与和重新参与护理。
