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社区药房和新型取药点在中低收入国家开展艾滋病病毒暴露前预防治疗启动和持续治疗的可行性和影响。

Feasibility and Impact of Community Pharmacy and Novel Pick-up Points for Antiretroviral Therapy Pre-exposure Prophylaxis Initiation and Continuation in Low and Middle-income Countries.

机构信息

Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Sunnyside Office Park, 32 Princess of Wales Terrace, Johannesburg, South Africa.

出版信息

Curr HIV/AIDS Rep. 2024 Nov 16;22(1):2. doi: 10.1007/s11904-024-00710-3.

Abstract

PURPOSE OF REVIEW

This review assesses recent developments in community access to pre-exposure prophylaxis (PrEP) for HIV prevention in low-and middle-income countries (LMICs). It examines literature on differentiated service delivery (DSD) and alternative delivery modes for PrEP, focusing on the role of community pharmacies and novel pick-up points. Key considerations include barriers to access, potential benefits, and strategies for implementation.

RECENT FINDINGS

Challenges to optimal HIV healthcare delivery persist globally, with LMICs facing greater barriers due to resource constraints and structural obstacles. Community pharmacies and novel pick-up points offer promising avenues to expand access to HIV medication, especially in hard-to-reach populations. However, operational complexities and regulatory frameworks present significant challenges. Recent initiatives, such as collaborative practice agreements and programmes by global health agencies, highlight efforts to integrate community pharmacies into HIV prevention and care delivery. Mobile health clinics and home delivery services have also shown promise in improving treatment coverage. Community pharmacies and novel pick-up points play a crucial role in enhancing access to HIV PrEP in LMICs. Despite challenges related to infrastructure, funding, and regulatory oversight, innovative strategies like DSD and mobile outreach offer opportunities to reach marginalized populations. Real-life examples from LMICs demonstrate the feasibility and effectiveness of leveraging community pharmacies for HIV treatment. However, addressing policy gaps, strengthening pharmacist training, and promoting patient-centred approaches are essential for scaling up access to PrEP. Collaboration between governments, health agencies, and local communities is key to realizing the full potential of community pharmacies in HIV prevention and care.

摘要

目的综述

本综述评估了在中低收入国家(LMICs)社区获得 HIV 预防用暴露前预防(PrEP)的最新进展。本文研究了差异化服务提供(DSD)和 PrEP 替代提供模式的文献,重点关注社区药房和新型取药点的作用。主要考虑因素包括准入障碍、潜在益处以及实施策略。

最新发现

全球范围内,优化 HIV 医疗服务提供仍面临挑战,资源有限和结构性障碍使得 LMICs 面临更大的障碍。社区药房和新型取药点为扩大 HIV 药物的获取提供了有前途的途径,特别是针对难以接触的人群。然而,运营复杂性和监管框架带来了重大挑战。最近的一些举措,如合作实践协议和全球卫生机构的方案,强调了将社区药房纳入 HIV 预防和护理服务的努力。移动健康诊所和家庭配送服务也显示出改善治疗覆盖率的潜力。

社区药房和新型取药点在提高 LMICs 中 HIV PrEP 可及性方面发挥着关键作用。尽管存在与基础设施、资金和监管监督相关的挑战,但创新战略,如 DSD 和移动外展,为接触边缘化人群提供了机会。来自 LMICs 的实际案例展示了利用社区药房提供 HIV 治疗的可行性和有效性。然而,解决政策差距、加强药剂师培训以及促进以患者为中心的方法对于扩大 PrEP 的可及性至关重要。政府、卫生机构和当地社区之间的合作是充分发挥社区药房在 HIV 预防和护理中的潜力的关键。

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PrEP distribution in pharmacies: a systematic review.药店中 PrEP 的分发:系统评价。
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