Popovic Nashira, Yang Qiuying, Campeau Laurence, Elliott Janelle, Williams Anson, Lima Viviane D, Sereda Paul, Cox Joseph
Centre for Communicable Disease and Infection Control, Public Health Agency of Canada, Ottawa, ON.
BC Centre for Excellence in HIV/AIDS, Vancouver, BC.
Can Commun Dis Rep. 2025 Jan 2;51(1):35-42. doi: 10.14745/ccdr.v51i01a05. eCollection 2025 Jan.
Measuring trends in HIV pre-exposure prophylaxis (HIV-PrEP) uptake is important to inform planning for prevention programs and policies. The HIV-PrEP-to-need ratio (PnR) is a construct used by public health organizations to explore disparities in the provision of HIV-PrEP across geographic areas and demographic categories (e.g., age, sex).
This is a retrospective database review study using administrative pharmacy data, containing limited demographic information, from nine Canadian provinces. Annual estimates of persons taking HIV-PrEP and PnR were generated using data from the company IQVIA and the BC Centre for Excellence on HIV/AIDS. Data on new HIV diagnoses were obtained from the National HIV Surveillance System. The PnR was defined as the number of HIV-PrEP users divided by the number of new HIV diagnoses annually and is interpreted as the number of HIV-negative people using HIV-PrEP each year for every person newly diagnosed with HIV.
In 2021, an estimated 23,644 individuals were prescribed HIV-PrEP, corresponding to an HIV-PrEP prevalence of 66.9 per 100,000 persons. This represents a 1.8-fold increase since 2018. The overall PnR was 16.8, meaning that for every person newly diagnosed with HIV, 17 HIV-negative individuals were taking HIV-PrEP. There were disparities between provinces (PnR range: 1.5/100,000-37.7/100,000) and between males and females (PnR 22.6 and 1.2, respectively). Females, individuals aged 0-19 years, and those in Manitoba, Saskatchewan and Prince Edward Island, had lower levels of HIV-PrEP use relative to epidemic need.
In Canada, the use of HIV-PrEP increased from 2018 to 2021 and uptake varied by age, sex and province. HIV-PrEP-to-need ratio is a useful measure to assess uptake of HIV-PrEP as a prevention strategy and could be used to explore disparities in provision across provinces and available demographic categories. However, PnR could be improved with more information on key populations and other attributes, such as race/ethnicity, socioeconomic status and residence of city/rural area.
衡量艾滋病病毒暴露前预防（HIV-PrEP）的使用趋势对于为预防项目和政策制定规划提供信息非常重要。HIV-PrEP需求比（PnR）是公共卫生组织用于探究不同地理区域和人口类别（如年龄、性别）在提供HIV-PrEP方面差异的一个指标。
这是一项回顾性数据库审查研究，使用了来自加拿大九个省份的行政药房数据，这些数据包含有限的人口信息。使用艾昆纬公司和不列颠哥伦比亚卓越艾滋病中心的数据生成了服用HIV-PrEP的人数和PnR的年度估计值。新的艾滋病病毒诊断数据来自国家艾滋病病毒监测系统。PnR定义为HIV-PrEP使用者数量除以每年新的艾滋病病毒诊断数量，解释为每年每例新诊断出艾滋病病毒的人中有多少HIV阴性者使用HIV-PrEP。
2021年，估计有23644人被开具HIV-PrEP处方，HIV-PrEP患病率为每10万人66.9例。这比2018年增长了1.8倍。总体PnR为16.8，这意味着每例新诊断出艾滋病病毒的人，有17名HIV阴性者正在服用HIV-PrEP。省份之间（PnR范围：1.5/10万-37.7/10万）以及男性和女性之间（PnR分别为22.6和1.2）存在差异。相对于流行需求，女性、0至19岁的个体以及马尼托巴省、萨斯喀彻温省和爱德华王子岛的居民，HIV-PrEP的使用水平较低。
在加拿大，2018年至2021年期间HIV-PrEP的使用有所增加，且使用情况因年龄、性别和省份而异。HIV-PrEP需求比是评估HIV-PrEP作为预防策略使用情况的一个有用指标，可用于探究不同省份和现有人口类别在提供方面的差异。然而，通过获取更多关于关键人群和其他属性（如种族/族裔、社会经济地位以及城市/农村居住地）的信息，可以改进PnR。
