School of Health and Society, University of Wollongong, Wollongong, Australia.
Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
AIDS Behav. 2024 Sep;28(9):3038-3050. doi: 10.1007/s10461-024-04386-z. Epub 2024 May 28.
Pre-exposure prophylaxis (PrEP) availability through the Pharmaceutical Benefits Scheme provides real potential for the elimination of HIV transmission in Australia, as evidenced by a rapid decline in HIV incidence among gay and bisexual men (GBM). However, HIV elimination will not be possible without also extending PrEP to other populations, including cisgender women. We conducted a scoping review to examine the extent to which PrEP access for cisgender women has been considered in Australia. A comprehensive search across five databases, grey literature, and hand search of references was conducted. A single reviewer conducted title and abstract screening and two reviewers completed full-text screening and data extraction. Nineteen documents were included in the final review and included both peer-reviewed journal articles and guidelines and strategies. Focused discussion of cisgender women's use of PrEP was largely missing from the literature and, although their use of PrEP is supported in some relevant guidelines, little has been done to actively develop strategies to inform cisgender women about PrEP as a precursor to prescribing for HIV prevention. Healthcare providers' narrow view of PrEP as being the domain of GBM further limits cisgender women's potential access. If HIV elimination in Australia is to be a reality, we need to develop mechanisms to specifically engage with cisgender women about PrEP.
暴露前预防(PrEP)通过药品福利计划(Pharmaceutical Benefits Scheme)提供,这为澳大利亚消除艾滋病毒传播提供了真正的潜力,这一点从男同性恋和双性恋者(GBM)中的艾滋病毒发病率迅速下降中可见一斑。然而,如果不将 PrEP 扩展到其他人群,包括跨性别女性,那么消除艾滋病毒是不可能的。我们进行了范围界定审查,以检查在澳大利亚,跨性别女性获得 PrEP 的程度。我们在五个数据库、灰色文献和参考文献的手工搜索中进行了全面搜索。一名评审员进行了标题和摘要筛选,两名评审员完成了全文筛选和数据提取。最终审查共纳入了 19 份文件,包括同行评议的期刊文章以及指南和策略。文献中很少有专门讨论跨性别女性使用 PrEP 的情况,尽管一些相关指南支持她们使用 PrEP,但在积极制定策略以告知跨性别女性 PrEP 作为预防艾滋病毒的一种手段方面,几乎没有采取任何措施。医疗保健提供者将 PrEP 狭隘地视为 GBM 的领域,这进一步限制了跨性别女性的潜在获得途径。如果澳大利亚要实现消除艾滋病毒,我们需要开发机制,专门与跨性别女性就 PrEP 进行接触。