Department of Medicine, University of Washington, Seattle, Washington, USA.
HIV/STD Program, Public Health-Seattle & King County, Seattle, Washington, USA.
Clin Infect Dis. 2023 Jul 26;77(2):252-257. doi: 10.1093/cid/ciad202.
Low-barrier care (LBC) for people with human immunodeficiency virus (HIV) is a differentiated service delivery strategy to engage people in HIV treatment who are not well-engaged in conventionally organized HIV medical care. The LBC approach is flexible, but experience suggests that the intervention has distinct core components. This review summarizes our experience implementing one model of LBC, the Max Clinic in Seattle; describes the core components of the intervention; and presents a framework for implementing low-barrier HIV care with the goal of providing a practical guide for clinical and public health leaders seeking to implement a new LBC program. A systematic approach to addressing key factors during LBC implementation can support practitioners to design an LBC approach that fits the local context while maintaining essential elements of the intervention.
针对人类免疫缺陷病毒 (HIV) 感染者的低门槛医疗服务 (LBC) 是一种差异化的服务提供策略，旨在让那些在常规组织的 HIV 医疗服务中参与度不高的人参与到 HIV 治疗中来。LBC 方法具有灵活性，但经验表明，干预措施具有明显的核心组成部分。本综述总结了我们在西雅图实施 LBC 模型（Max Clinic）的经验；描述了干预措施的核心组成部分；并提出了一个实施低门槛 HIV 护理的框架，旨在为寻求实施新的 LBC 计划的临床和公共卫生领导人提供实用指南。在 LBC 实施过程中，采用系统的方法来解决关键因素，可以为从业者提供支持，设计出适合当地情况的 LBC 方法，同时保持干预措施的基本要素。
