Outcomes of a policy to prioritize populations with expected healthcare barriers for subsidized PrEP care in Amsterdam, the Netherlands: a cross-sectional study.

Autor:	Wijstma E; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.; Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, the Netherlands., Jongen VW; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.; Stichting hiv monitoring, Amsterdam, the Netherlands., Boyd A; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.; Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, the Netherlands.; Stichting hiv monitoring, Amsterdam, the Netherlands., de Vries HJC; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.; Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, the Netherlands.; Amsterdam Public Health Research Institute (APH), Amsterdam, the Netherlands.; Amsterdam UMC location University of Amsterdam, Department of Dermatology, Amsterdam, The Netherlands., Loeff MFSV; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.; Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, the Netherlands.; Amsterdam Public Health Research Institute (APH), Amsterdam, the Netherlands.; Amsterdam UMC location University of Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands., Prins M; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.; Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, the Netherlands.; Amsterdam Public Health Research Institute (APH), Amsterdam, the Netherlands.; Amsterdam UMC location University of Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands., Hoornenborg E; Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.; Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, the Netherlands.; Amsterdam Public Health Research Institute (APH), Amsterdam, the Netherlands.; Amsterdam UMC location University of Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	AIDS (London, England) [AIDS] 2024 Sep 30. Date of Electronic Publication: 2024 Sep 30.
DOI:	10.1097/QAD.0000000000004027
Abstrakt:	Objective: The Dutch HIV pre-exposure prophylaxis (PrEP) pilot provided subsidized PrEP care to maximum 2,900 individuals at a time in Amsterdam. Populations with expected barriers to accessing PrEP elsewhere were prioritized for program inclusion. We evaluated their prior sexual health service engagement and PrEP need. Design: Cross-sectional analysis using enrolment data. Methods: We included individuals ever enrolled in the PrEP program at the Center for Sexual Health (CSH) Amsterdam between 2019-2023. We calculated the proportion belonging to higher-priority groups (i.e.,<25 years old, transgender, sex worker, uninsured or migrant). We defined classes of sexual health service engagement in the 12 months preceding enrolment using latent class analysis (LCA). We compared engagement classes, sexual behavior and positivity of HIV and sexually transmitted infections (STI) between higher- and lower-priority groups. Results: 2,004/4,075 (49%) individuals enrolled belonged to higher-priority groups. LCA showed three classes of prior engagement: "Newly engaged" (14%,n = 551) were new to the CSH-Amsterdam; "PrEP initiators" (40%,n = 1,642) previously visited the CSH-Amsterdam but had not used PrEP; "PrEP experienced" individuals (46%,n = 1,882) previously accessed PrEP. Higher-priority groups were more often "newly engaged" or "PrEP-initiators" than "PrEP-experienced". Higher-priority groups less often had condomless anal sex with casual partners or chemsex in the prior six months. Positivity of bacterial STI was similar between higher-priority (n = 300/2,004, 15.0%) and lower-priority (n = 315/2,071, 15.2%) groups. 13/14 HIV diagnoses at enrolment were in higher-priority groups. Conclusion: Higher-priority populations had less often previously used sexual health services and accounted for most new HIV diagnoses at enrolment. Engaging these populations in sexual healthcare, including PrEP, should be stressed. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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