British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
St. Paul's Hospital Ambulatory Pharmacy, St. Paul's Hospital, Vancouver, British Columbia, Canada.
PLoS One. 2023 Mar 15;18(3):e0283025. doi: 10.1371/journal.pone.0283025. eCollection 2023.
In 2018, the pre-exposure prophylaxis (PrEP) program was initiated in British Columbia (BC), Canada, providing PrEP at no cost to qualifying residents. This observational study discussed the steps to develop key evidence-based monitoring indicators and their calculation using real-time data. The indicators were conceptualized, developed, assessed and approved by the Technical Monitoring Committee of representatives from five health authority regions in BC, the BC Ministry of Health, the BC Centre for Disease Control, and the BC Centre for Excellence in HIV/AIDS. Indicator development followed the steps adopted from the United States Centers for Disease Control and Prevention framework for program evaluation in public health. The assessment involved eight selection criteria: data quality, indicator validity, existing scientific evidence, indicator informativeness, indicator computing feasibility, clients' confidentiality maintenance capacity, indicator accuracy, and administrative considerations. Clients' data from the provincial-wide PrEP program (January 2018-December 2020) shows the indicators' calculation. The finalized 14 indicators included gender, age, health authority, new clients enrolled by provider type and by the health authority, new clients dispensed PrEP, clients per provider, key qualifying HIV risk factor(s), client status, PrEP usage type, PrEP quantity dispensed, syphilis and HIV testing and incident cases, and adverse drug reaction events. Cumulative clients' data (n = 6966; 99% cis-gender males) identified an increased new client enrollment and an unexpected drop during the COVID-19 pandemic. About 80% dispensed PrEP from the Vancouver Coastal health authority. The HIV incidence risk index for men who have sex with men score ≥10 was the most common qualifying risk factor. The framework we developed integrating indicators was applied to monitor our PrEP program, which could help reduce the public health impact of HIV.
2018 年，加拿大不列颠哥伦比亚省（BC）启动了暴露前预防（PrEP）项目，为符合条件的居民提供免费的 PrEP。本观察性研究讨论了制定关键循证监测指标及其使用实时数据计算的步骤。这些指标是由来自 BC 五个卫生当局地区、BC 卫生部、BC 疾病控制中心和 BC 艾滋病卓越中心的代表组成的技术监测委员会概念化、制定、评估和批准的。指标的制定遵循了美国疾病控制与预防中心公共卫生项目评估框架中采用的步骤。评估涉及八个选择标准：数据质量、指标有效性、现有科学证据、指标信息性、指标计算可行性、客户保密性维护能力、指标准确性和管理考虑因素。来自全省范围的 PrEP 项目（2018 年 1 月至 2020 年 12 月）的客户数据显示了指标的计算。最终确定的 14 个指标包括性别、年龄、卫生当局、按服务提供商类型和卫生当局登记的新客户、分发 PrEP 的新客户、每位服务提供商的客户、主要合格的 HIV 风险因素、客户状况、PrEP 使用类型、分发的 PrEP 数量、梅毒和 HIV 检测和发病病例以及药物不良反应事件。累积的客户数据（n=6966；99% cis 性别男性）表明新客户的登记人数增加，并且在 COVID-19 大流行期间出现了意外下降。约 80%的 PrEP 来自温哥华沿海卫生当局分发。与男性发生性行为的男性的 HIV 发病率风险指数≥10 是最常见的合格风险因素。我们开发的整合指标的框架用于监测我们的 PrEP 计划，这有助于减少 HIV 对公共卫生的影响。
