A Review of Implementation Strategies to Enhance PrEP Delivery for People Experiencing Housing Insecurity: Advancing a Multifaceted High-Touch, Low-Barrier Approach.

IF 3.7 2区医学 Q2 INFECTIOUS DISEASES Current HIV/AIDS Reports Pub Date : 2024-11-22 DOI:10.1007/s11904-024-00714-z

Jennifer Velloza, Nicky J Mehtani, Matthew D Hickey, Elizabeth Imbert, Ayesha Appa, Elise D Riley

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Abstract

Purpose of review: This review summarizes key implementation strategies to advance oral and long-acting PrEP delivery for unstably housed people in the United States.

Recent findings: People experiencing homelessness and housing instability face barriers to PrEP uptake and adherence including lack of safe medication storage, competing basic needs, insurances issues, and/or mental health or substance use disorders. Recent advancements in HIV treatment and prevention provide evidence on high-touch, low-barrier implementation approaches to address these challenges. We compiled these approaches into a multi-component implementation strategy, "SHELTER", which includes: low-barrier primary care, case management, incentives, outreach, care coordination, multidisciplinary provider collaboration, data tracking, and robust provider-patient relationships. The US has fallen short of our Ending the Epidemic targets, in part due to challenges in PrEP delivery for people experiencing housing instability. SHELTER provides a comprehensive approach for considering critical components of HIV prevention for this population that can be used in future oral and long-acting PrEP programs.

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加强向住房无保障者提供 PrEP 的实施策略综述：推进多方面、高接触、低障碍的方法。

综述目的：本综述总结了美国为住房不稳定人群提供口服长效 PrEP 的主要实施策略：最近的研究结果：无家可归和住房不稳定的人群在接受和坚持 PrEP 治疗方面面临障碍，包括缺乏安全的药物储存、相互竞争的基本需求、保险问题和/或精神健康或药物使用障碍。艾滋病治疗和预防领域的最新进展为我们提供了高接触、低障碍的实施方法，以应对这些挑战。我们将这些方法汇编成一个多成分实施战略 "庇护所"，其中包括：低障碍初级保健、个案管理、激励措施、外联、护理协调、多学科提供者合作、数据跟踪以及健全的提供者与患者关系。美国未能实现 "终结流行病 "的目标，部分原因是为住房不稳定人群提供 PrEP 所面临的挑战。SHELTER 提供了一种全面的方法，用于考虑该人群艾滋病预防的关键要素，可用于未来的口服和长效 PrEP 计划。

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来源期刊

Current HIV/AIDS Reports INFECTIOUS DISEASES-

CiteScore

8.10

自引率

2.20%

发文量

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.