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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >HIV prescriptions on the frontlines: Primary care providers' use of antiretrovirals for prevention in the Southeast United States, 2017
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HIV prescriptions on the frontlines: Primary care providers' use of antiretrovirals for prevention in the Southeast United States, 2017

机译：艾滋病毒前线处方：初级护理提供者使用抗逆转录病毒预防美国的预防，2017年

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摘要

HIV disproportionately affects persons in Southeast United States. Primary care providers (PCPs) are vital for HIV prevention. Data are limited about their prescribing of antiretrovirals (ARVs) for prevention, including nonoccupational post-exposure prophylaxis (nPEP), pre-exposure prophylaxis (PrEP), and antiretroviral therapy (ART). We examined these practices to assess gaps. During April-August 2017, we conducted an online survey of PCPs in Atlanta, Baltimore, Baton Rouge, Miami, New Orleans, and Washington, DC to assess HIV-related knowledge, attitudes and practices. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were used to estimate correlates of nPEP, PrEP and ART prescribing practices. Adjusting for MSA and specialty, the weighted sample (n = 820, 29.6% adjusted response rate) comprised 60.2% white and 59.4% females. PCPs reported ever prescribing nPEP (31.0%), PrEP (18.1%), and ART (27.2%). Prescribing nPEP was associated with nPEP familiarity (aPR = 2.63, 95% CI 1.59, 4.35) and prescribing PrEP (aPR = 3.57, 95% CI 2.78, 4.55). Prescribing PrEP was associated with PrEP familiarity (aPR = 4.35, 95% CI 2.63, 7.14), prescribing nPEP (aPR = 5.00, 95% CI 2.00, 12.50), and providing care for persons with HIV (aPR = 1.56, 95% CI 1.06, 2.27). Prescribing ART was associated with nPEP familiarity (aPR = 1.89, 95% CI 1.27, 2.78) and practicing in outpatient public practice versus hospital-based facilities (aPR = 2.14 95% CI 1.51, 3.04), and inversely associated with collaborations involving specialists (aPR = 0.60, 95% CI 0.42, 0.86). A minority of PCPs surveyed from the Southeast report ever prescribing ARVs for prevention. Future efforts should include enhancing HIV care coordination and developing strategies to increase use of biomedical tools.
机译：艾滋病毒不成比例地影响美国东南部的人。初级保健提供者（PCP）对艾滋病毒预防至关重要。数据限于它们对预防的抗逆转录病毒（ARV）的规定，包括非聚合发生的曝光预防（NPEP），预曝光预防（PREP）和抗逆转录病毒治疗（ART）。我们审查了这些做法来评估差距。在2017年4月至8月期间，我们在亚特兰大，巴尔的摩，巴吞鲁日，迈阿密，新奥尔良和华盛顿特区进行了在线调查，评估了与艾滋病毒相关的知识，态度和实践。调整后患病率比率（APR）和95％的置信区间（CI）用于估算NPEP，PREP和艺术规定实践的相关性。调整MSA和专业，加权样品（N = 820,29.6％调节的响应率）组成60.2％白色和59.4％的女性。 PCP报告了NPEP（31.0％），准备（18.1％）和艺术（27.2％）。处方NPEP与NPEP熟悉（APR = 2.63,95％CI 1.59,4.35）和处方预备（APR = 3.57,95％CI 2.78,4.55）。规定准备与预备熟悉程度有关（APR = 4.35,95％CI 2.63,7.14），处方NPEP（APR = 5.00,95％CI 2.00,12.50），并为艾滋病毒提供护理（APR = 1.56,95％CI 1.06,2.27）。处方艺术与NPEP熟悉程度有关（APR = 1.89,95％CI 1.27,2.78），并且在门诊公共练习中练习与医院为基础的设施（APR = 2.14 95％CI 1.51,3.04），以及与涉及专家的合作关系（ APR = 0.60,95％CI 0.42,0.86）。从东南部报告调查的少数PCP有没有规定预防的ARV。未来的努力应包括提高艾滋病护理协调和发展战略以增加生物医学工具的使用。

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