PDF(Pubmed)
Abstract：
UNASSIGNED: Adolescent girls and young women (AGYW) in East and southern Africa experience a disproportionate burden of HIV incidence. Integrating HIV pre-exposure prophylaxis (PrEP) within existing programs is a key component of addressing this disparity.
UNASSIGNED: We evaluated an oral PrEP program integrated into post-abortion care (PAC) in Kenya from March 2021 to November 2022. Technical advisors trained staff at PAC clinics on PrEP delivery, abstracted program data from each clinic, and collected data on structural characteristics. Utilizing a modified Poisson regression, we estimated the effect of structural factors on the probability of PrEP offer and uptake.
UNASSIGNED: We abstracted data on 6877 AGYW, aged 15-30 years, across 14 PAC clinics. PrEP offers were made to 57.4% of PAC clients and 14.1% initiated PrEP. Offers were associated with an increased probability at clinics that had consistent supply of PrEP (relative risk (RR):1.81, 95% CI: 1.1-2.95), inconsistent HIV testing commodities (RR: 1.89, 95% CI: 1.29-2.78), had all providers trained (RR: 1.65, 95% CI: 1.01, 2.68), and were public (RR: 1.89, 95% CI: 1.29-2.78). These same factors were associated with PrEP uptake: consistent supply of PrEP (RR: 2.71, 95% CI: 1.44-5.09), inconsistent HIV testing commodities (RR: 2.55, 95% CI: 1.39-4.67), all providers trained (RR: 2.61, 95% CI: 1.38-4.92), and were public (RR: 2.55, 95% CI: 1.39-4.67).
UNASSIGNED: Greater success with integration of HIV prevention into reproductive health services will likely require investments in systems, such as human resources and PrEP and HIV testing commodities, to create stable availability and ensure consistent access.
UNASSIGNED: PrEDIRA 2 was supported by funding from Children\'s Investment Fund Foundation (R-2001-04433). Ms. Zia was funded by the NIH Ruth L. Kirchstein pre-doctoral award (5F31HD105494-02) and Dr. Heffron was funded by National Institute of Mental Health (K24MH123371).
UNASSIGNED: We evaluated an oral PrEP program integrated into post-abortion care (PAC) in Kenya from March 2021 to November 2022. Technical advisors trained staff at PAC clinics on PrEP delivery, abstracted program data from each clinic, and collected data on structural characteristics. Utilizing a modified Poisson regression, we estimated the effect of structural factors on the probability of PrEP offer and uptake.
UNASSIGNED: We abstracted data on 6877 AGYW, aged 15-30 years, across 14 PAC clinics. PrEP offers were made to 57.4% of PAC clients and 14.1% initiated PrEP. Offers were associated with an increased probability at clinics that had consistent supply of PrEP (relative risk (RR):1.81, 95% CI: 1.1-2.95), inconsistent HIV testing commodities (RR: 1.89, 95% CI: 1.29-2.78), had all providers trained (RR: 1.65, 95% CI: 1.01, 2.68), and were public (RR: 1.89, 95% CI: 1.29-2.78). These same factors were associated with PrEP uptake: consistent supply of PrEP (RR: 2.71, 95% CI: 1.44-5.09), inconsistent HIV testing commodities (RR: 2.55, 95% CI: 1.39-4.67), all providers trained (RR: 2.61, 95% CI: 1.38-4.92), and were public (RR: 2.55, 95% CI: 1.39-4.67).
UNASSIGNED: Greater success with integration of HIV prevention into reproductive health services will likely require investments in systems, such as human resources and PrEP and HIV testing commodities, to create stable availability and ensure consistent access.
UNASSIGNED: PrEDIRA 2 was supported by funding from Children\'s Investment Fund Foundation (R-2001-04433). Ms. Zia was funded by the NIH Ruth L. Kirchstein pre-doctoral award (5F31HD105494-02) and Dr. Heffron was funded by National Institute of Mental Health (K24MH123371).
摘要：
东非和南部非洲的少女和年轻妇女（AGYW）经历了不成比例的艾滋病毒发病率负担。将HIV暴露前预防（PrEP）纳入现有计划是解决这一差距的关键组成部分。
■我们评估了2021年3月至2022年11月在肯尼亚纳入堕胎后护理（PAC）的一项口头PrEP计划。技术顾问对PAC诊所的工作人员进行了PrEP交付培训，从每个诊所提取程序数据，并收集有关结构特征的数据。利用改进的泊松回归，我们估计了结构因素对PrEP提供和摄取概率的影响。
■我们在6877AGYW上提取了数据，年龄在15-30岁之间,14个PAC诊所。向57.4%的PAC客户提供了PrEP，14.1%的客户发起了PrEP。提供与持续供应PrEP的诊所的概率增加相关（相对风险（RR）：1.81，95％CI：1.1-2.95），不一致的艾滋病毒检测商品(RR：1.89，95%CI：1.29-2.78)，所有提供者都接受了培训(RR：1.65，95%CI：1.01，2.68)，并且是公开的（RR：1.89，95%CI：1.29-2.78）。这些相同的因素与PrEP摄取相关：PrEP的持续供应（RR：2.71，95％CI：1.44-5.09），不一致的艾滋病毒检测商品(RR：2.55，95%CI：1.39-4.67)，所有受过培训的提供者(RR：2.61，95%CI：1.38-4.92)，并且是公开的（RR：2.55，95%CI：1.39-4.67）。
将艾滋病毒预防纳入生殖健康服务的更大成功可能需要对系统进行投资，如人力资源、PrEP和艾滋病毒检测商品，以创建稳定的可用性并确保一致的访问。
■PrEDIRA2得到了儿童投资基金基金会（R-2001-04433）的资助。Zia女士由NIHRuthL.Kirchstein博士前奖项（5F31HD105494-02）资助，Heffron博士由美国国家精神卫生研究所（K24MH123371）资助。
■我们评估了2021年3月至2022年11月在肯尼亚纳入堕胎后护理（PAC）的一项口头PrEP计划。技术顾问对PAC诊所的工作人员进行了PrEP交付培训，从每个诊所提取程序数据，并收集有关结构特征的数据。利用改进的泊松回归，我们估计了结构因素对PrEP提供和摄取概率的影响。
■我们在6877AGYW上提取了数据，年龄在15-30岁之间,14个PAC诊所。向57.4%的PAC客户提供了PrEP，14.1%的客户发起了PrEP。提供与持续供应PrEP的诊所的概率增加相关（相对风险（RR）：1.81，95％CI：1.1-2.95），不一致的艾滋病毒检测商品(RR：1.89，95%CI：1.29-2.78)，所有提供者都接受了培训(RR：1.65，95%CI：1.01，2.68)，并且是公开的（RR：1.89，95%CI：1.29-2.78）。这些相同的因素与PrEP摄取相关：PrEP的持续供应（RR：2.71，95％CI：1.44-5.09），不一致的艾滋病毒检测商品(RR：2.55，95%CI：1.39-4.67)，所有受过培训的提供者(RR：2.61，95%CI：1.38-4.92)，并且是公开的（RR：2.55，95%CI：1.39-4.67）。
将艾滋病毒预防纳入生殖健康服务的更大成功可能需要对系统进行投资，如人力资源、PrEP和艾滋病毒检测商品，以创建稳定的可用性并确保一致的访问。
■PrEDIRA2得到了儿童投资基金基金会（R-2001-04433）的资助。Zia女士由NIHRuthL.Kirchstein博士前奖项（5F31HD105494-02）资助，Heffron博士由美国国家精神卫生研究所（K24MH123371）资助。
