Acceptability and Feasibility of Implementing a Home-Based HIV Pre-Exposure Prophylaxis Program in an Urban Clinic.

IF 3.4 2区 医学 Q2 INFECTIOUS DISEASES
Tiffany Yuh, Linden Lalley-Chareczko, Dante' Zanders, Harlan Shaw, Terrence Spencer, Dana Serafin, Helen Koenig, Florence Momplaisir
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Abstract

Personal and structural barriers to HIV pre-exposure prophylaxis (PrEP) care result in its underutilization and premature discontinuation. A home-based PrEP program comprised of telemedicine visits and/or self-administered lab testing may address some of these barriers. Our objective was to assess the acceptability and feasibility of a home-based PrEP program among stakeholders at an urban HIV and primary care clinic. We used the consolidated framework for implementation research to evaluate determinants of successful implementation of the program. We surveyed and interviewed PrEP patients and their health care team. In a baseline survey of PrEP users (n = 112) administered between May 2021 and August 2022, 65% expressed interest in switching to the home-based PrEP program. Seventeen patients over the course of follow-up through December 2023 started home-based PrEP, including 12 patients who completed both a telemedicine visit and a self-administered lab kit, and 5 patients who completed only a telemedicine visit. Of these, over 80% had positive feedback on the telemedicine visits. Survey results demonstrated excellent acceptability and feasibility of the lab kits. Patients indicated in interviews that the home-based PrEP program provided the strong advantage of convenience. Despite mixed feelings from PrEP providers on telemedicine visits (n = 5), most felt that the program made PrEP care delivery easier for patients and would encourage their patients to use the program if it were a good fit. Barriers to program success included shipping delays and staff turnover during program implementation. In conclusion, uptake of the home-based program was low but program participants expressed high acceptability.

在城市诊所实施家庭艾滋病暴露前预防计划的可接受性和可行性。
艾滋病毒暴露前预防疗法(PrEP)护理中存在的个人和结构性障碍导致该疗法使用不足和过早中断。由远程医疗访问和/或自控实验室检测组成的家庭式 PrEP 计划可以解决其中的一些障碍。我们的目标是评估一个城市艾滋病和初级保健诊所的利益相关者对基于家庭的 PrEP 计划的接受程度和可行性。我们使用实施研究的综合框架来评估成功实施该计划的决定因素。我们对 PrEP 患者及其医疗团队进行了调查和访谈。在 2021 年 5 月至 2022 年 8 月期间对 PrEP 使用者(n = 112)进行的基线调查中,65% 的人表示有兴趣改用家庭式 PrEP 计划。在截至 2023 年 12 月的随访过程中,有 17 名患者开始在家中使用 PrEP,其中 12 名患者同时完成了远程医疗访问和自制实验包,5 名患者仅完成了远程医疗访问。其中,超过 80% 的患者对远程医疗访问给予了积极评价。调查结果显示,化验包的可接受性和可行性都非常好。患者在访谈中表示,居家 PrEP 计划具有极大的便利优势。尽管 PrEP 医疗服务提供者对远程医疗访问(5 人)的感受不一,但大多数人认为该计划使 PrEP 患者的护理工作变得更加轻松,如果该计划非常适合他们,他们会鼓励患者使用该计划。项目成功的障碍包括项目实施过程中的运输延误和人员流动。总之,居家计划的接受率较低,但计划参与者表示接受度很高。
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来源期刊
AIDS patient care and STDs
AIDS patient care and STDs 医学-传染病学
CiteScore
7.00
自引率
22.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world. AIDS Patient Care and STDs coverage includes: Prominent AIDS medications, therapies, and antiretroviral agents HIV/AIDS-related diseases, infections, and complications Challenges of medication adherence Current prevention techniques for HIV The latest news and developments on other STDs Treatment/prevention options, including pre- and post-exposure prophylaxis
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