Abstract：
OBJECTIVE: People who use or would benefit from pre-exposure prophylaxis (PrEP) for HIV infection are disproportionately affected by sexually transmitted infections (STIs). Integrating STI services when offering PrEP fosters synergies and efficiencies in response to HIV/STI and promotes people-centred care. Including guidance on STI interventions for people on PrEP may facilitate implementation and uptake. We conducted a global review of national PrEP guidance documents and analysed the inclusion of recommendations for the provision of STI services by country level of income.
METHODS: We searched national PrEP guidance documents published by WHO Member States through the WHO, the Joint United Nations Programme on HIV/AIDS (UNAIDS) databases, the PrEPWatch repository and Google. Information on a range of STI-related interventions was extracted from documents available by October 2023.
RESULTS: Of the 113 national PrEP guidance documents retrieved, STIs were mentioned in 77% (90/117). Viral hepatitis B testing and vaccination were recommended by most high-income countries (HICs) and low-income and middle-income countries (LMICs). Recommendation for syphilis testing was prominent in HICs (91%) and moderately noted in LMICs (68%). Gonorrhoea and chlamydia testing was recommended frequently in HICs (88%) and 42% in LMICs. However, the review noted that, to a much lesser extent, specific type of testing for these pathogens was mentioned. Recommendation for quarterly STI testing for syphilis, gonorrhoea and chlamydia was ubiquitous, while the need to offer STI partner services was rarely mentioned.
CONCLUSIONS: PrEP services offer an opportunity for improved and expanded STI services, increasing person-centred care and addressing STI epidemics alongside HIV. Our review highlights the strengths and gaps in incorporating critical STI interventions into national PrEP normative guidance. Addressing these gaps through a stepwise approach and increasing targeted testing and partner services can help improve quality of care and support an effective response to HIV and other STIs.
METHODS: We searched national PrEP guidance documents published by WHO Member States through the WHO, the Joint United Nations Programme on HIV/AIDS (UNAIDS) databases, the PrEPWatch repository and Google. Information on a range of STI-related interventions was extracted from documents available by October 2023.
RESULTS: Of the 113 national PrEP guidance documents retrieved, STIs were mentioned in 77% (90/117). Viral hepatitis B testing and vaccination were recommended by most high-income countries (HICs) and low-income and middle-income countries (LMICs). Recommendation for syphilis testing was prominent in HICs (91%) and moderately noted in LMICs (68%). Gonorrhoea and chlamydia testing was recommended frequently in HICs (88%) and 42% in LMICs. However, the review noted that, to a much lesser extent, specific type of testing for these pathogens was mentioned. Recommendation for quarterly STI testing for syphilis, gonorrhoea and chlamydia was ubiquitous, while the need to offer STI partner services was rarely mentioned.
CONCLUSIONS: PrEP services offer an opportunity for improved and expanded STI services, increasing person-centred care and addressing STI epidemics alongside HIV. Our review highlights the strengths and gaps in incorporating critical STI interventions into national PrEP normative guidance. Addressing these gaps through a stepwise approach and increasing targeted testing and partner services can help improve quality of care and support an effective response to HIV and other STIs.
摘要：
目的：使用暴露前预防（PrEP）治疗HIV感染的人受到性传播感染（STIs）的不成比例的影响。在提供PrEP时整合性传播感染服务可促进应对艾滋病毒/性传播感染的协同作用和效率，并促进以人为本的护理。包括针对PrEP人群的性传播感染干预指导，可能会促进实施和吸收。我们对国家PrEP指导文件进行了全球审查，并分析了按国家收入水平提供科技创新服务的建议。
方法：我们检索了世卫组织会员国通过世卫组织发布的国家PrEP指导文件，联合国艾滋病毒/艾滋病联合规划署(艾滋病规划署)数据库，PrEPWatch存储库和Google。有关一系列与性传播感染有关的干预措施的信息是从2023年10月之前提供的文件中提取的。
结果：在检索到的113份国家PrEP指导文件中，在77%（90/117）中提到了性传播感染。大多数高收入国家（HIC）以及低收入和中等收入国家（LMIC）建议进行乙型病毒性肝炎检测和疫苗接种。梅毒检测的建议在HIC中突出(91%)，在LMIC中中等程度(68%)。建议在HIC中经常进行淋病和衣原体检测（88％），在LMIC中经常进行42％。然而,审查指出，在更小的程度上，提到了针对这些病原体的具体检测类型.梅毒季度性传播感染检测建议，淋病和衣原体无处不在，虽然很少提到提供科技创新合作伙伴服务的必要性。
结论：PrEP服务提供了改进和扩展STI服务的机会，增加以人为本的护理，并与艾滋病毒一起解决性传播感染流行病。我们的审查强调了将关键科技创新干预措施纳入国家PrEP规范指南的优势和差距。通过逐步方法解决这些差距，增加有针对性的检测和合作伙伴服务，可以帮助提高护理质量，并支持有效应对艾滋病毒和其他性传播感染。
方法：我们检索了世卫组织会员国通过世卫组织发布的国家PrEP指导文件，联合国艾滋病毒/艾滋病联合规划署(艾滋病规划署)数据库，PrEPWatch存储库和Google。有关一系列与性传播感染有关的干预措施的信息是从2023年10月之前提供的文件中提取的。
结果：在检索到的113份国家PrEP指导文件中，在77%（90/117）中提到了性传播感染。大多数高收入国家（HIC）以及低收入和中等收入国家（LMIC）建议进行乙型病毒性肝炎检测和疫苗接种。梅毒检测的建议在HIC中突出(91%)，在LMIC中中等程度(68%)。建议在HIC中经常进行淋病和衣原体检测（88％），在LMIC中经常进行42％。然而,审查指出，在更小的程度上，提到了针对这些病原体的具体检测类型.梅毒季度性传播感染检测建议，淋病和衣原体无处不在，虽然很少提到提供科技创新合作伙伴服务的必要性。
结论：PrEP服务提供了改进和扩展STI服务的机会，增加以人为本的护理，并与艾滋病毒一起解决性传播感染流行病。我们的审查强调了将关键科技创新干预措施纳入国家PrEP规范指南的优势和差距。通过逐步方法解决这些差距，增加有针对性的检测和合作伙伴服务，可以帮助提高护理质量，并支持有效应对艾滋病毒和其他性传播感染。
