中国 PrEP/PEP 服务提供模式的探索:在东部、中部和西部地区开展试点。

IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Global health & medicine Pub Date : 2024-10-31 DOI:10.35772/ghm.2024.01048
Zhen Jiang, Qi Wang, Jun Liang, Yuzhou Gu, Zhigang Han, Jie Li, Yake Xu, Youran Zhang, Xuehua Zhang, Jiahui Zhang, Jie Xu, Fan Lv
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摘要

自2017年起,我国开始了以控制人类免疫缺陷病毒(HIV)为目标的暴露前预防(PrEP)/暴露后预防(PEP)服务试点探索。必须优先总结试点经验,找出在提供服务方面存在的差距。2023 年 6 月至 10 月,在中国东部、中部和西部选择了三个具有两年 PrEP/PEP 试点经验的省会城市。开发了一个结构信息集体工具,作为确定 PrEP/PEP 服务程序审查关键环节和步骤的框架。形成了两种主要的服务模式,包括由专业医疗机构主导的独立线下服务模式和多机构(医疗机构/社区组织/互联网平台)线上线下协作服务模式。试点经验将 PrEP/PEP 纳入艾滋病预防工作的机会概念化,并说明了实现高水平艾滋病预防和护理连续性的优化路径。需要注意并解决整合过程中的系统性障碍。当务之急是建立一个现实可行的在线和离线监测系统,以实现标准化、安全、简化和便捷服务之间的平衡。
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Exploration of PrEP/PEP service delivery model in China: A pilot in eastern, central and western region.

Since 2017, China has started a pilot exploration of pre-exposure prophylaxis (PrEP)/post-exposure prophylaxis (PEP) service aiming for human immunodeficiency virus (HIV) control. Efforts to summarize the pilot experience and sort out the gaps in service provision must be prioritized. In June-October, 2023, three provincial capital cities with two years of PrEP/PEP pilot experience in eastern, central and western China were chosen. A structural information collective tool was developed, as a framework to identify key links and steps in reviewing service procedures for PrEP/PEP service. Two main service models have been formed, including the independent offline service model led by professional health institutions and Multi-agencies (health institution/Community Based Organizations (CBOs)/Internet platform) online and offline collaborative service model. The pilot experience conceptualizes opportunities to integrate PrEP/PEP into HIV prevention efforts and, illustrates the optimizing path to move forward to reach for a high level HIV prevention and care continuum. Systematic barriers during the process of integration need to be noted and addressed. It is urgent to establish a realistic and feasible online and offline monitoring system to achieve a balance between standardized, safe, simplified and convenient services.

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