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首页> 外文期刊>JMIR public health and surveillance. >Clinicians are inclined to prescribe HIV pre-exposure prophylaxis for persons at high risk of HIV but are concerned about the lack of guidelines: An online survey of 31 provinces in China
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Clinicians are inclined to prescribe HIV pre-exposure prophylaxis for persons at high risk of HIV but are concerned about the lack of guidelines: An online survey of 31 provinces in China

机译：临床医生倾向于为艾滋病病毒风险高的人开出艾滋病毒前暴露预防，但关注缺乏指导方针：在中国31个省份的在线调查

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BACKGROUND:Pre-exposure prophylaxis (PrEP) is an effective HIV prevention measure. Clinicians play a crucial role in PrEP implementation, and their knowledge, attitudes, and career experience may affect their willingness to prescribe PrEP. However, little is known about the attitudes and willingness of clinicians to prescribe PrEP in countries without PrEP-specific guidelines.OBJECTIVE:We aimed to determine the factors associated with clinicians being willing to prescribe PrEP in China.METHODS:Between May and June 2019, we conducted an online cross-sectional survey of clinicians in 31 provinces across the six administrative regions in China on the WeChat smartphone app platform. Multivariable logistic regression was used to determine factors associated with willingness to prescribe PrEP.RESULTS:Overall, 777 HIV clinicians completed the survey. Most of the respondents had heard of PrEP (563/777, 72.5%), 31.9% (248/777) thought that PrEP was extremely effective for reducing the risk of HIV infection, and 47.2% (367/777) thought that it was necessary to provide PrEP to high-risk groups. After adjusting for age, gender, ethnicity, and educational background of the clinicians, the following factors signi?cantly increased the odds of the clinicians being willing to prescribe PrEP: having worked for more than 10 years, compared to 5 years or less (adjusted odds ratio [aOR] 2.82, 95% CI 1.96-4.05); having treated more than 100 patients living with HIV per month, compared to 50 patients or fewer (aOR 4.16, 95% CI 2.85-6.08); and having heard of PrEP (aOR 7.32, 95% CI 4.88-10.97). Clinicians were less likely to be willing to prescribe PrEP if they were concerned about poor adherence to PrEP (aOR 0.66, 95% CI 0.50-0.88), the lack of PrEP clinical guidelines (aOR 0.47, 95% CI 0.32-0.70), and the lack of drug indications for PrEP (aOR 0.49, 95% CI 0.32-0.76).CONCLUSIONS:About half of all clinicians surveyed were willing to prescribe PrEP, but most surveyed had a low understanding of PrEP. Lack of PrEP clinical guidelines, lack of drug indications, and less than 11 years of work experience were the main barriers to the surveyed clinicians' willingness to prescribe PrEP. Development of PrEP clinical guidelines and drug indications, as well as increasing the availability of PrEP training, could help improve understanding of PrEP among clinicians and, thus, increase the number willing to prescribe PrEP.?Sitong Cui, Haibo Ding, Xiaojie Huang, Hui Wang, Weiming Tang, Sequoia I Leuba, Zehao Ye, Yongjun Jiang, Wenqing Geng, Junjie Xu, Hong Shang. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 04.06.2021.
机译：背景：预防前预防（PREP）是一种有效的艾滋病毒预防措施。临床医生在准备实施中发挥至关重要的作用，他们的知识，态度和职业经验可能会影响他们的规定准备的意愿。但是，对于没有预采样的指导方针，临床医生在国家规定准备的态度和意愿的知名度毫无熟悉。目的：我们旨在确定与临床医生有愿意在中国开展准备的因素。方法：2019年5月至6月之间，我们在六个行政区域临床上对六个行政区域的临床医生进行了在线横断面调查，在中国的六个行政地区。多变量的逻辑回归用于确定与规定准备意愿相关的因素：结果：总体而言，777名艾滋病毒临床医生完成了调查。大多数受访者都听说过Prep（563/777,72.5％），31.9％（248/777）认为Prep对降低艾滋病毒感染风险非常有效，47.2％（367/777）认为它是必须为高风险群体提供准备。调整临床医生的年龄，性别，种族和教育背景后，以​​下因素Signi？突然增加了临床医生愿意规定准备的几率：在5年以上工作，而5年或更少（调整赔率比[AOR] 2.82,95％CI 1.96-4.05）;每月治疗100多名患有艾滋病毒的患者，而50名患者或更少（AOR 4.16,95％CI 2.85-6.08）;听说过Prep（AOR 7.32,95％CI 4.88-10.97）。临床医生不太可能愿意愿意在遵守准备贫困方面的准备（AOR 0.66,95％CI 0.50.88），缺乏预备临床指南（AOR 0.47,95％CI 0.32-0.70），以及缺乏制备药物适应症（AOR 0.49,95％CI 0.32-0.76）。结论：大约一半被调查的临床医生愿意开票，但大多数受访者对准备的理解很低。缺乏预备临床指南，缺乏药物指示，少于11年的工作经验是对调查临床医生的规定准备意愿的主要障碍。制定预备临床指南和药物指示，以及增加预备培训的可用性，有助于提高临床医生之间的准备，从而增加愿意规定准备的数字.?ITong崔，海博鼎，小杰黄，慧王，威明唐，红杉，我莱巴，泽嫂叶，永军江，文庆耿，俊杰徐，洪尚。最初在JMIR公共卫生和监视（HTTPS://Publichealth.jmir.org），04.06.2021。

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