Prep provision in community organizations: a comparative study with conventional services.

Autor:	Grangeiro A; Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil., Massa PA; Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil., Escuder MM; Secretaria de Estado da Saúde de São Paulo. Instituto de Saúde. São Paulo, SP, Brasil., Zucchi EM; Universidade Católica de Santos. Programa de Pós-Graduação em Saúde Coletiva. Santos, SP, Brasil., Sala EA; Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil., Oliveira EA; Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil., Fini R; Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil., Dourado I; Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil., Magno L; Universidade do Estado da Bahia. Departamento de Ciências da Vida. Salvador, BA, Brasil., Leite BO; Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil., Bruxvoort K; University of Alabama at Birmingham. Birmingham, AL, United States of America., MacCarthy S; University of Alabama at Birmingham. Birmingham, AL, United States of America., Couto MT; Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil., Peres MFT; Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil.
Jazyk:	Portuguese; English
Zdroj:	Revista de saude publica [Rev Saude Publica] 2024 Oct 11; Vol. 58 (suppl 1), pp. 9s. Date of Electronic Publication: 2024 Oct 11 (Print Publication: 2024).
DOI:	10.11606/s1518-8787.2024058005914
Abstrakt:	Objective: To evaluate whether adolescents from sexual minorities who initiated pre-exposure prophylaxis (PrEP) in community-based organizations (COs) are more socially and HIV-vulnerable compared with their counterparts from a conventional health service. In addition, to evaluate whether these adolescents had more timely access to prophylaxis. Methods: A PrEP demonstration study was conducted in the city of São Paulo in two COs, located in the center (CO-center) and the outskirts (CO-outskirts), and a conventional HIV testing service (CTA-center). Between 2020 and 2022, cisgender male adolescents who have sex with men (aMSM), transgender and gender diverse adolescents (aTTrans) aged 15 to 19 years, HIV-negative, with higher-risk practices for HIV were eligible for PrEP. Indicators of timely access and vulnerabilities of adolescents initiating PrEP in COs were analyzed using CTA-center as a reference and multinomial logistic regression. Results: 608 adolescents initiated PrEP in COs and CTA-center. Adolescents from COs were associated with a shorter time to PrEP initiation (1-7 days; CO-outskirts: ORa = 2.91; 95%CI 1.22-6.92; CO-center: ORa = 1.91; 95%CI 1.10-3.31); and a lower housing Human Development Index (HDI) (CO-center: ORa = 0.97; 95%CI 0.94-1.00; CO-outskirts: ORa = 0.82; 95%CI 0.78-0.86). In CO-outskirts, there was an increased chance of adolescents being younger (ORa = 3.06; 95%CI 1.63-5.75) and living closer to the service (ORa = 0.82; 95%CI 0.78-0.86, mean 7.8 km). While adolescents from the CO-center were associated with greater prior knowledge of PrEP (ORa = 2.01; 95%CI 1.10-3.91) and high-risk perception (ORa = 2.02; 95%CI 1.18-3.44), adolescents from the COs were not associated with higher-risk sexual practices and situations of vulnerability to HIV. Conclusion: The provision of PrEP in the COs facilitated access for vulnerable adolescents and may contribute to reducing inequities.
Databáze:	MEDLINE
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