Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
RTI International, Raleigh, NC; and.
J Acquir Immune Defic Syndr. 2023 Dec 1;94(4):290-300. doi: 10.1097/QAI.0000000000003290.
BACKGROUND: Data are needed to assess the capacity of HIV care facilities to implement recommended Ending the HIV Epidemic activities. SETTING: US HIV care facilities. METHODS: We analyzed 2021 survey data from 514 facilities that were recruited from a census of facilities providing care to a national probability sample of US adults with HIV. We present weighted estimates of facility characteristics, services, and policies and estimates of the proportion of all US HIV patients attending these facilities. RESULTS: Among HIV care facilities, 37% were private practices, 72% were in areas with population >1 million, and 21% had more than 1000 HIV patients. Most provided preexposure prophylaxis (83%) and postexposure prophylaxis (84%). More than 67% of facilities provided HIV-specific stigma or discrimination training for all staff (covering 70% of patients) and 66% provided training on cultural competency (covering 74% of patients). A majority of patients attended facilities that provided on-site access to HIV/sexually transmitted infection (STI) transmission risk reduction counseling (89%); fewer had on-site access to treatment for substance use disorders (35%). We found low provision of on-site assistance with food banks or meal delivery (14%) and housing (33%). Approximately 71% of facilities reported using data to systematically monitor patient retention in care. On-site access to adherence tools was available at 58% of facilities; 29% reported notifying patients of missed prescription pickups. CONCLUSION: Results indicate some strengths that support Ending the HIV Epidemic-recommended strategies among HIV care facilities, such as high availability of preexposure prophylaxis/postexposure prophylaxis, as well as areas for improvement, such as provision of staff antistigma trainings and adherence supports.
背景:需要数据来评估艾滋病毒护理机构实施建议的终结艾滋病流行活动的能力。
地点:美国艾滋病毒护理机构。
方法:我们分析了 2021 年从为全国艾滋病毒成年患者提供护理的全国概率样本的护理设施普查中招募的 514 个设施的调查数据。我们介绍了设施特征、服务和政策的加权估计数,以及在这些设施就诊的所有美国艾滋病毒患者的比例估计数。
结果:在艾滋病毒护理机构中,37%是私人诊所,72%位于人口超过 100 万的地区,21%有 1000 多名艾滋病毒患者。大多数机构提供暴露前预防(83%)和暴露后预防(84%)。超过 67%的机构为所有员工提供艾滋病毒特定的耻辱感或歧视培训(覆盖 70%的患者),66%提供文化能力培训(覆盖 74%的患者)。大多数患者就诊的机构提供现场艾滋病毒/性传播感染(STI)传播风险降低咨询(89%);较少的机构提供现场药物滥用障碍治疗(35%)。我们发现,现场提供食品银行或送餐服务(14%)和住房援助(33%)的情况很少。大约 71%的机构报告使用数据系统监测患者在护理中的保留率。58%的机构提供现场获得依从性工具的机会;29%的机构报告通知患者错过处方取药。
结论:结果表明,艾滋病毒护理机构在实施终结艾滋病流行建议的策略方面存在一些优势,如暴露前预防/暴露后预防的高可用性,以及需要改进的领域,如提供员工抗耻辱培训和依从性支持。
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Cochrane Database Syst Rev. 2001
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