Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models.

Autor: Iniesta C; Spanish HIV/AIDS Research Network, National Centre of Epidemiology, Health Institute Carlos III, Madrid, Spain.; National AIDS Programme, Ministry of Health, Madrid, Spain., Coll P; BCN Checkpoint, Barcelona, España., Barberá MJ; STI Unit Vall d´Hebron-Drassanes, Infectious Diseases Department, University Hospital Vall d'Hebron, Barcelona, Spain., García Deltoro M; Infectious Disease Service, Consortium General University Hospital of Valencia, Valencia, Spain., Camino X; Infectious Disease Service, University Hospital of Donostia, San Sebastian, Spain., Fagúndez G; National AIDS Programme, Ministry of Health, Madrid, Spain., Díaz A; HIV and STI Surveillance Unit, National Centre of Epidemiology, Health Institute Carlos III, Madrid, Spain., Polo R; National AIDS Programme, Ministry of Health, Madrid, Spain.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Feb 08; Vol. 16 (2), pp. e0246129. Date of Electronic Publication: 2021 Feb 08 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0246129
Abstrakt: Background: Pre-exposure prophylaxis (PrEP) is an effective and cost-effective strategy for HIV prevention. Spain carried out an implementation study in order to assess the feasibility of implementing PrEP programmes within its heterogeneous health system.
Methods: Observational longitudinal study conducted on four different types of health-care setting: a community centre (CC), a sexually transmitted infections clinic (STIC), a hospital-based HIV unit (HBHIVU) and a hospital-based STI unit (HBSTIU). We recruited gay, bisexual and other men who have sex with men (GBSM) and transgender women at risk of HIV infections, gave them PrEP and monitored clinical, behavioural PrEP-related and satisfaction information for 52 weeks. We collected perceptions on PrEP implementation feasibility from health-care professionals participating in the study.
Results: A total of 321 participants were recruited, with 99.1% being GBMSM. Overall retention was 87.2% and it was highest at the CC (92.6%). Condom use decreased during the study period, while STIs did not increase consistently. The percentage of people who did not miss any doses of PrEP during the previous week remained at over 93%. No HIV seroconversions occurred. We observed overall decreases in GHB (32.5% to 21.8%), cocaine (27.5% to 21.4%), MDMA (25.7% to 14.3%), speed (11.4% to 5.7%) and mephedrone use (10.7% to 5.0%). The overall participant satisfaction with PrEP was 98.6%. Health-care professionals' perceptions of PrEP feasibility were positive, except for the lack of personnel.
Conclusions: PrEP implementation is feasible in four types of health-care settings. Local specificities have to be taken into consideration while implementing PrEP.
Competing Interests: The participation of private companies in this study does not alter our adherence to PLOS ONE policies on sharing data and materials.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje