A behavioral economics approach to enhancing HIV preexposure and postexposure prophylaxis implementation.

Current opinion in HIV and AIDS Pub Date : 2024-07-01 Epub Date: 2024-04-26 DOI:10.1097/COH.0000000000000860

Jingjing Li, Yaxin Liu, Eric Nehl, Joseph D Tucker

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Abstract

Purpose of review: The 'PrEP cliff' phenomenon poses a critical challenge in global HIV PrEP implementation, marked by significant dropouts across the entire PrEP care continuum. This article reviews new strategies to address 'PrEP cliff'.

Recent findings: Canadian clinicians have developed a service delivery model that offers presumptive PEP to patients in need and transits eligible PEP users to PrEP. Early findings are promising. This service model not only establishes a safety net for those who were not protected by PrEP, but it also leverages the immediate salience and perceived benefits of PEP as a natural nudge towards PrEP use. Aligning with Behavioral Economics, specifically the Salience Theory, this strategy holds potential in tackling PrEP implementation challenges.

Summary: A natural pathway between PEP and PrEP has been widely observed. The Canadian service model exemplifies an innovative strategy that leverages this organic pathway and enhances the utility of both PEP and PrEP services. We offer theoretical insights into the reasons behind these PEP-PrEP transitions and evolve the Canadian model into a cohesive framework for implementation.

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以行为经济学方法加强艾滋病暴露前和暴露后预防措施的实施。

审查目的：PrEP悬崖 "现象是全球艾滋病PrEP实施过程中面临的一个严峻挑战，其特点是整个PrEP护理过程中都有大量患者退出。本文回顾了应对 "PrEP 悬崖 "的新策略：加拿大临床医生开发了一种服务提供模式，为有需要的患者提供推定的 PrEP，并将符合条件的 PEP 使用者转为 PrEP。早期研究结果令人鼓舞。这种服务模式不仅为那些没有得到 PrEP 保护的人建立了一个安全网，而且还利用了 PEP 的直接显著性和可感知的益处，自然而然地推动了 PrEP 的使用。这一策略符合行为经济学，特别是显著性理论，在应对 PrEP 的实施挑战方面具有潜力。加拿大的服务模式是一种创新策略的典范，它充分利用了这一有机途径，提高了 PEP 和 PrEP 服务的效用。我们从理论上深入探讨了 PEP 和 PrEP 过渡背后的原因，并将加拿大模式发展成为一个具有凝聚力的实施框架。

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Current opinion in HIV and AIDS

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