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iPARTY研究:2022 - 2023年通过远程医疗增加新加坡男男性行为者的暴露前预防服务可及性和覆盖范围

iPARTY study: Increasing pre-exposure prophylaxis access and reach via telehealth for young men who have sex with men in Singapore 2022-2023.

作者信息

Lee Pei Hua, Lim Justin Y, Kumar P Arun, Tan Zhi Hui, Tan Rayen Bing Hui, Choy Chiaw Yee, Tan Rayner Kay Jin, Chio Martin Tw, Wong Chen Seong

机构信息

Infectious Diseases, National Centre for Infectious Diseases, Singapore.

Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.

出版信息

Ann Acad Med Singap. 2025 Mar 27;54(3):160-169. doi: 10.47102/annals-acadmedsg.2024285.

Abstract

INTRODUCTION

Although pre-exposure prophylaxis (PrEP) has been available in Singapore since 2016, its uptake among gay, bisexual and other men-who-have-sex-with-men (GBMSM) is low. The iPARTY study was established to evaluate the acceptability and feasibility of PrEP and a PrEP teleconsultation service for young GBMSM aged 18 to 29 years.

METHOD

A total of 53 young GBMSM were enrolled in the iPARTY study. They had a total of 5 in-person consultations and teleconsultations, at 12-week intervals. Laboratory tests and quarterly baseline surveys were performed to assess PrEP adherence, sexual behaviour, and incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs).

RESULTS

Thirty-five participants completed the entire 12-month follow-up. Most participants had positive experiences with PrEP teleconsultations. There was a statistically significant fall in participants' aggregate Patient Health Questionnaire-9 scores throughout the study. Self-reported PrEP adherence decreased over the course of the study, denoting improved mental health. Although self-reported condom use for anal intercourse and participants' risk perception of HIV decreased after PrEP adoption, there was no statisti-cally significant increase in STI incidence.

CONCLUSION

This pilot project has shown that PrEP services provide an opportunity for YMSM to access sexual health testing, treatment and counselling, and may even have tangible benefits on the mental health of this population. Teleconsultation is shown to be a suitable platform for the delivery of such services. Collaborative initiatives are crucial to further enhance the affordability and accessibility of PrEP in Singapore, and to improve patient adherence.

摘要

引言

尽管暴露前预防(PrEP)自2016年起在新加坡就已可用,但其在男同性恋、双性恋和其他与男性发生性关系的男性(GBMSM)中的接受程度较低。开展iPARTY研究是为了评估PrEP以及针对18至29岁年轻GBMSM的PrEP远程会诊服务的可接受性和可行性。

方法

共有53名年轻GBMSM参与了iPARTY研究。他们共进行了5次面对面咨询和远程会诊,间隔为12周。进行了实验室检测和季度基线调查,以评估PrEP依从性、性行为以及人类免疫缺陷病毒(HIV)和其他性传播感染(STIs)的发生率。

结果

35名参与者完成了整个12个月的随访。大多数参与者对PrEP远程会诊有积极体验。在整个研究过程中,参与者的患者健康问卷-9总分有统计学意义的下降。自我报告的PrEP依从性在研究过程中有所下降,表明心理健康状况有所改善。尽管在采用PrEP后,自我报告的肛交时使用避孕套情况以及参与者对HIV的风险认知有所下降,但性传播感染的发生率没有统计学意义的显著增加。

结论

该试点项目表明,PrEP服务为年轻男男性行为者(YMSM)提供了获得性健康检测、治疗和咨询的机会,甚至可能对该人群的心理健康有切实益处。远程会诊被证明是提供此类服务的合适平台。合作倡议对于进一步提高新加坡PrEP的可承受性和可及性以及改善患者依从性至关重要。

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