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Pre-exposure Prophylaxis: The Delivery Challenge

机译：暴露前预防：分娩挑战

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摘要

HIV pre-exposure prophylaxis (PrEP), despite its efficacy, has been slow in uptake throughout the world. This article discusses the operational and service delivery complexity, based on early real-world experience, with some recommendations on how this promising intervention could be made more available. Currently, access to PrEP is made complex by restricting delivery to dedicated health facilities, as well as requirements around HIV testing and toxicity monitoring. Expanding to verticalized services that focus on well-defined populations where HIV testing and treatment programmes already exist, has proven relatively simple. Providing PrEP outside of this environment has yet to be demonstrated at any scale, and will likely require innovative thinking addressing the regulatory and clinical environment, so as to ensure easier access to this promising HIV prevention tool.
机译：尽管有HIV暴露前预防（PrEP）的功效，但在世界范围内吸收缓慢。本文根据早期的实际经验，讨论了操作和服务交付的复杂性，并就如何使这种有前途的干预措施提供了一些建议。当前，通过限制向专用医疗机构的运送以及围绕HIV检测和毒性监测的要求，使PrEP的获取变得复杂。事实证明，扩展到针对已经存在艾滋病毒检测和治疗计划的明确人群的垂直服务相对简单。在这种环境之外提供PrEP尚无任何规模的证明，并且可能需要针对法规和临床环境的创新思维，以确保更容易地获得这种有前途的HIV预防工具。

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