Tối Ưu Hóa Việc Sử Dụng Dự Phòng Trước Phơi Nhiễm Dài Hạn Bằng Tiêm Để Ngăn Ngừa HIV Cho Nam Quan Hệ Tình Dục Đồng Giới

Springer Science and Business Media LLC - Tập 27 - Trang 2606-2616 - 2023
Lorraine T. Dean1, Zachary Predmore2, Alexandra Skinner3, Siena Napoleon4, Philip A. Chan4, Julia Raifman3
1Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
2RAND Health Care, RAND Corporation, Boston, USA
3Department of Health Law, Policy & Management, Boston University School of Public Health, Boston University, Boston, USA
4Department of Medicine, Brown University, Providence, USA

Tóm tắt

Dự phòng trước phơi nhiễm (PrEP) là một công cụ ngăn ngừa HIV có hiệu quả cao. PrEP tiêm dài hạn (LAI-PrEP) cung cấp một cơ hội khác để giảm thiểu HIV. Tuy nhiên, cách mà những cá nhân có nguy cơ sẽ xem xét LAI-PrEP so với các phương thức khác vẫn chưa rõ ràng. Chúng tôi đã tiến hành một thí nghiệm lựa chọn phân biệt về sở thích đối với PrEP trong một mẫu gồm 688 nam giới đồng tính, song tính, và những nam giới quan hệ tình dục với nam khác. Chúng tôi đã phân tích sở thích về phương thức sử dụng, tác dụng phụ, chi phí tiền tệ và chi phí thời gian bằng cách sử dụng mô hình logit điều kiện và dự đoán sở thích cho các tùy chọn PrEP. LAI-PrEP được ưa chuộng hơn, mặc dù phương thức sử dụng là thuộc tính ít quan trọng nhất của PrEP. Tác dụng phụ là thuộc tính quan trọng nhất ảnh hưởng đến sở thích cho PrEP (44% quyết định); chi phí là thuộc tính quan trọng thứ hai (35% quyết định). PrEP không có tác dụng phụ là sở thích quan trọng nhất, tiếp theo là chi phí hàng tháng ra khỏi túi là $0. Các chuyên gia và nhà hoạch định chính sách muốn tăng cường tỉ lệ sử dụng PrEP nên giữ chi phí ở mức thấp, giao tiếp rõ ràng về tác dụng phụ của PrEP, và cho phép sử dụng phương thức tiêm PrEP mà bệnh nhân ưa chuộng, bao gồm cả LAI-PrEP.

Từ khóa

#PrEP #LAI-PrEP #HIV #nam giới đồng tính #thí nghiệm lựa chọn phân biệt #sở thích sử dụng PrEP

Tài liệu tham khảo

Sullivan PS, Johnson AS, Pembleton ES, et al. Epidemiology of HIV in the USA: epidemic burden, inequities, contexts, and responses. Lancet. 2021;397(10279):1095–106. Fields SD, Tung E. Patient-focused selection of PrEP medication for individuals at risk of HIV: a narrative review. Infect Dis Therapy. 2021;10(1):165–86. U.S. Food & Drug Administration. FDA Approves First Injectable Treatment for HIV Pre-Exposure Prevention. https://www.fda.gov/news-events/press-announcements/fda-approves-first-injectable-treatment-hiv-pre-exposure-prevention. (2021). accessed January 10, 2022. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United Stated and dependent areas, 2015. HIV Surveill Rep. 2016;27. Hess KL, Hu X, Lansky A, Mermin J, Hall HI. Lifetime risk of a diagnosis of HIV infection in the United States. Ann Epidemiol. 2017;27(4):238–43. Centers for Disease Control and Prevention. HIV in the United States and Dependent Areas. https://www.cdc.gov/hiv/statistics/overview/ataglance.html (2021). Accessed April 6, 2022. Ya-lin AH, Zhu W, Smith DK, Harris N, Hoover KW. HIV preexposure prophylaxis, by race and ethnicity—United States, 2014–2016. Morb Mortal Wkly Rep. 2018;67(41):1147. Doblecki-Lewis S, Liu A, Feaster D, et al. Healthcare access and PrEP continuation in San Francisco and Miami following the US PrEP demo project. J Acquir Immune Defic Syndr. 2017;74(5):531. Galea JT, Kinsler JJ, Salazar X, et al. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations. Int J STD AIDS. 2011;22(5):256–62. Crosby RA, Geter A, DiClemente RJ, Salazar LF. Acceptability of condoms, circumcision and PrEP among young black men who have sex with men: a descriptive study based on effectiveness and cost. Vaccines. 2014;2(1):129–37. Smith DK, Toledo L, Smith DJ, Adams MA, Rothenberg R. Attitudes and program preferences of African-American urban young adults about pre-exposure prophylaxis (PrEP). AIDS Educ Prev. 2012;24(5):408–21. Chan PA, Mena L, Patel R, et al. Retention in care outcomes for HIV pre-exposure prophylaxis implementation programmes among men who have sex with men in three US cities. J Int AIDS Soc. 2016;19(1):20903. Department of Health and Human Services. Opportunities to improve HIV prevention and Care Delivery to Medicaid and CHIP Beneficiaries. https://www.medicaid.gov/federal-policy-guidance/downloads/cib120116.pdf. (2016). Accessed Dec 14, 2021. Currie D. HIV prevention pill welcomed as new tool in AIDS battle: medication comes with high price tag. Nation’s Health. 2012;42(7):1–12. Kubicek K, Arauz-Cuadra C, Kipke MD. Attitudes and perceptions of biomedical HIV prevention methods: voices from young men who have sex with men. Arch Sex Behav. 2015;44(2):487–97. Kay ES, Pinto RM. Is insurance a barrier to HIV preexposure prophylaxis? Clarifying the issue. Am J Public Health. 2020;110(1):61–4. National Institute of Allergy and Infectious Diseases. Infographic—Long-Acting Forms of HIV Prevention. https://www.niaid.nih.gov/diseases-conditions/long-acting-forms-hiv-prevention (2019). Accessed Dec 14, 2021. Bridges JF, Selck FW, Gray GE, McIntyre JA, Martinson NA. Condom avoidance and determinants of demand for male circumcision in Johannesburg, South Africa. Health Policy Planning. 2011;26(4):298–306. Phillips KA, Maddala T, Johnson FR. Measuring preferences for health care interventions using conjoint analysis: an application to HIV testing. Health Serv Res. 2002;37(6):1681–705. Bridges JF, Hauber AB, Marshall D, et al. Conjoint analysis applications in health—a checklist: a report of the ISPOR Good Research Practices for Conjoint Analysis Task Force. Value Health. 2011;14(4):403–13. Sosnowy C, Predmore Z, Dean LT, et al. Paying for PrEP: A qualitative study of cost factors that impact pre-exposure prophylaxis uptake in the US. International Journal of STD & AIDS. 2022:09564624221132406. To access the Appendix click on the Details tab in the article online. Dubov A, Ogunbajo A, Altice FL, Fraenkel L. Optimizing access to PrEP based on MSM preferences: results of a discrete choice experiment. AIDS Care. 2019;31(5):545–53. Beckham S, Sanchez T, Zlotorzynska M, et al. Preferences for implementing long-acting injectable pre-exposure prophylaxis among cisgender men who have sex with men in the United States. J Int AIDS Soc. 2021;24(S4):29–31. Gutierrez JI, Dubov A, Altice F, Vlahov D. Measuring PrEP preferences among US military men who have sex with men: results of an adaptive choice based conjoint analysis study. 2021. Wray TB, Chan PA, Klausner JD, Ward LM, Ocean E. Gay, bisexual, and other men who have sex with men who are not on oral PrEP may be less interested in available injectable products than in oral PrEP: examining individual-level determinants of interest and barriers across products. AIDS Behav. 2022:1–12. Dunville R, Harper C, Johns MM, et al. Awareness and willingness to use biomedical prevention strategies for HIV among sexual and gender minority youth: results from a national survey. J Adolesc Health. 2021;68(1):199–206. Asiago-Reddy EA, McPeak J, Scarpa R, et al. Perceived access to PrEP as a critical step in engagement: a qualitative analysis and discrete choice experiment among young men who have sex with men. PLoS ONE. 2022;17(1): e0258530. Keith K. New guidance On PrEP: support services must be covered without cost-sharing. health affairs blog. (2021). Accessed Jan 19 2022. Ryan M, Gerard K. Using discrete choice experiments to value health care programmes: current practice and future research reflections. Appl Health Econ Health Policy. 2003;2(1):55–64. Sullivan PS, Khosropour CM, Luisi N, et al. Bias in online recruitment and retention of racial and ethnic minority men who have sex with men. J Med Internet Res. 2011;13(2): e38. Ballard AM, Cardwell T, Young AM. Fraud detection protocol for web-based research among men who have sex with men: development and descriptive evaluation. JMIR Public Health Surveill. 2019;5(1): e12344. Kates J, Dawson L, Horn TH, et al. Insurance coverage and financing landscape for HIV treatment and prevention in the USA. Lancet. 2021.