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Abstract：
Objectives. To determine the percentage of US outpatient substance use treatment facilities that offer HIV preexposure prophylaxis (PrEP). Methods. We used a retrospective cross-sectional design with data from the National Substance Use and Mental Health Services Survey, which was administered to directors of US outpatient substance use treatment facilities in 2021. We evaluated the percentage of outpatient substance use treatment facilities offering PrEP and factors associated with the likelihood of offering PrEP. Results. We included 12 182 outpatient substance use treatment facilities. Of these, 637 (5.2%) offered PrEP. Offering HIV treatment (adjusted odds ratio [AOR] = 45.3; 95% confidence interval [CI] = 36.0, 56.9) and offering programs for LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) people (AOR = 1.3; 95% CI = 1.0, 1.6) were associated with higher likelihoods of offering PrEP. Conclusions. PrEP is highly effective and recommended for patients at risk for HIV from injection drug use. Nearly 95% of US outpatient substance use treatment facilities did not offer PrEP-a missed opportunity for harm reduction through primary HIV prevention. Public Health Implications. Diversification of the array of available HIV PrEP options and the ongoing HIV and opioid use epidemics require outpatient substance use treatment facilities to expand PrEP availability. (Am J Public Health. 2024;114(8):833-837. https://doi.org/10.2105/AJPH.2024.307699).
摘要：
Objectives.确定提供HIV暴露前预防（PrEP）的美国门诊药物使用治疗设施的百分比。方法。我们使用来自国家物质使用和心理健康服务调查的数据进行回顾性横断面设计，该法案于2021年实施给美国门诊药物使用治疗机构的主管。我们评估了提供PrEP的门诊药物使用治疗设施的百分比以及与提供PrEP的可能性相关的因素。结果。我们包括12182个门诊药物使用治疗设施。其中,637（5.2%）提供了PrEP。提供HIV治疗（调整后的优势比[AOR]=45.3；95％置信区间[CI]=36.0，56.9），并为LGBTQ提供计划（女同性恋，同性恋,双性恋,变性人,和奇怪或质疑）的人（AOR=1.3；95％CI=1.0，1.6）与提供PrEP的较高可能性相关。Conclusions.PrEP是非常有效的，建议用于注射药物使用有HIV风险的患者。近95％的美国门诊药物使用治疗设施没有提供PrEP-通过初级HIV预防减少伤害的机会。公共卫生影响。多种可用的HIVPrEP选择以及持续的HIV和阿片类药物使用流行病的多样化需要门诊药物使用治疗设施来扩大PrEP的可用性。（AmJ公共卫生。在2024年5月30日印刷之前在线发布：e1-e5。https://doi.org/10.2105/AJPH.2024.307699).
