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急诊科患者对在城市急诊科获得人类免疫缺陷病毒暴露前预防服务的看法。

Emergency Department Patients' Perspectives on Being Offered Human Immunodeficiency Virus Pre-Exposure Prophylaxis Services in an Urban Emergency Department.

作者信息

Solnick Rachel E, Gonzalez-Argoti Tatiana, Bauman Laurie J, Rael Christine Tagliaferri, Mantell Joanne E, Calderon Yvonne, Cowan Ethan, Hoffman Susie

机构信息

Icahn School of Medicine at Mount Sinai Hospital, Department of Emergency Medicine, New York, New York, USA.

Albert Einstein College of Medicine, Bronx, New York, USA.

出版信息

AIDS Patient Care STDS. 2025 May;39(5):192-202. doi: 10.1089/apc.2025.0009. Epub 2025 Apr 29.

Abstract

HIV pre-exposure prophylaxis (PrEP) is underutilized in the United States. Emergency departments (EDs) can be strategic locations for initiating PrEP; however, knowledge concerning patients' receptivity to ED PrEP programs is limited. This study explores ED patients' perspectives on PrEP service delivery and their preferences for implementation. Semi-structured qualitative interviews were conducted with 15 potentially PrEP-eligible ED patients to examine their receptiveness to PrEP services, preferences for delivery methods, and logistical considerations. Most participants were open to learning about PrEP in the ED, provided it did not delay care, occur during distress, or compromise privacy. Universal PrEP education was viewed as reducing stigma and increasing awareness, while targeted screening was considered efficient. Participants strongly preferred receiving information in person rather than via videos or pamphlets. Concerns included ensuring ED staff expertise and maintaining privacy during PrEP-related discussions. Opinions on initiating same-day PrEP versus prescriptions or referrals varied, with participants valuing flexibility and linkage to care. This first qualitative study of ED patients' perspectives on PrEP services highlights general receptiveness, with key concerns about privacy, expertise, and wait times. Patient-centered approaches, such as integrating services into ED workflows, offering flexible initiation options, and providing privacy, can address barriers and enhance the feasibility of ED-based PrEP programs.

摘要

在美国,艾滋病毒暴露前预防(PrEP)的使用率较低。急诊科(EDs)可以成为启动PrEP的重要场所;然而,关于患者对急诊科PrEP项目接受度的了解有限。本研究探讨了急诊科患者对PrEP服务提供的看法及其对实施方式的偏好。对15名可能符合PrEP条件的急诊科患者进行了半结构化定性访谈,以考察他们对PrEP服务的接受度、对提供方式的偏好以及后勤方面的考虑。大多数参与者愿意在急诊科了解PrEP,前提是不耽误治疗、不在痛苦时进行或不影响隐私。普遍的PrEP教育被视为可减少耻辱感并提高认识,而有针对性的筛查则被认为效率更高。参与者强烈倾向于亲自接收信息,而不是通过视频或宣传册。担忧包括确保急诊科工作人员的专业知识以及在与PrEP相关的讨论中保持隐私。对于当天启动PrEP与开具处方或转诊的意见各不相同,参与者重视灵活性和与医疗服务的衔接。这项关于急诊科患者对PrEP服务看法的首次定性研究突出了总体接受度,以及对隐私、专业知识和等待时间的主要担忧。以患者为中心的方法,如将服务整合到急诊科工作流程中、提供灵活的启动选项以及提供隐私保护,可以消除障碍并提高基于急诊科的PrEP项目的可行性。

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