PrEP Method Switching: Will it Yield Greater Coverage of HIV Protection? Applying Lessons Learned from Family Planning to Guide Future Research in the Context of PrEP Choice.

IF 3.7 2区 医学 Q2 INFECTIOUS DISEASES Current HIV/AIDS Reports Pub Date : 2024-10-01 Epub Date: 2024-07-24 DOI:10.1007/s11904-024-00704-1
Courtney McGuire, Margaret A Atieno, Theresa Hoke, Patriciah Jeckonia, Kevin K'orimba, Lara Lorenzetti, Kenneth Ngure, Marie Merci Niyibeshaho, Njambi Njuguna, Kristine Torjesen, Virginia Fonner
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Abstract

Purpose of review: Despite the growing availability of oral PrEP, coverage remains suboptimal. Through the introduction of additional PrEP methods, including vaginal rings and long-acting injectable formulations, health systems globally are on the cusp of offering PrEP methods that vary by route of administration, efficacy, and frequency of use. With PrEP choice, it will be important to explore PrEP use patterns to better understand how the ability to choose and switch products affects coverage and continuation. In this review, we draw parallels with family planning (FP) by summarizing how method choice and product switching affected contraceptive coverage globally, synthesize what is known about PrEP product switching, and outline evidence gaps to help guide future research on PrEP switching in the context of choice.

Recent findings: Decades of research in FP has demonstrated that product switching is common and can lead to more satisfaction and increases in contraceptive use. While research on PrEP product switching is nascent, findings suggest switching is common, and that providing more than one PrEP option can increase coverage. Key evidence gaps include understanding product switching in the context of full versus constrained choice, switching in the context of temporary need, and developing interventions that promote product switching for those who could benefit. Providing choice and allowing people to start, stop, and switch products according to their needs and desires is a core component of a rights-based approach to HIV prevention. More research is needed to better understand what drives use patterns, including switching, and how to leverage choice to improve coverage. Standard definitions -some of which have been proposed in this review-are needed to inform comparable measurement. Finally, there is a need to holistically frame PrEP use to acknowledge changes in need over the life course, thus making method switching a standard part of HIV prevention.

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PrEP 方法转换:它会带来更大的 HIV 防护覆盖面吗?在 PrEP 选择的背景下,运用从计划生育中汲取的经验教训指导未来的研究。
审查目的:尽管口服的 PrEP 越来越多,但覆盖率仍不理想。通过引入更多的 PrEP 方法,包括阴道环和长效注射制剂,全球卫生系统即将提供因给药途径、疗效和使用频率而异的 PrEP 方法。有了 PrEP 的选择,就必须探索 PrEP 的使用模式,以便更好地了解选择和转换产品的能力如何影响覆盖面和持续性。在本综述中,我们总结了方法选择和产品转换如何影响全球避孕药具的覆盖率,从而将其与计划生育(FP)相提并论,综述了有关 PrEP 产品转换的已知情况,并概述了证据缺口,以帮助指导未来在选择背景下对 PrEP 转换的研究:几十年来对计划生育的研究表明,产品转换很常见,并能提高满意度和增加避孕药具的使用。虽然有关 PrEP 产品转换的研究刚刚起步,但研究结果表明,产品转换很常见,提供一种以上的 PrEP 选择可提高覆盖率。主要的证据缺口包括:了解在完全选择与受限选择的情况下的产品转换、在临时需求的情况下的产品转换,以及制定干预措施,促进那些能够从中受益的人转换产品。提供选择并允许人们根据自己的需求和愿望开始、停止和转换产品,是基于权利的艾滋病预防方法的核心组成部分。需要开展更多的研究,以更好地了解是什么推动了使用模式,包括转换,以及如何利用选择来提高覆盖率。需要制定标准定义--本综述提出了一些标准定义--以便进行可比衡量。最后,需要从整体上对 PrEP 的使用进行界定,以承认在生命过程中需求的变化,从而使方法转换成为艾滋病预防的一个标准组成部分。
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来源期刊
Current HIV/AIDS Reports
Current HIV/AIDS Reports INFECTIOUS DISEASES-
CiteScore
8.10
自引率
2.20%
发文量
45
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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