背景:英国承诺致力于到2030年实现零艾滋病毒新发感染和艾滋病毒相关死亡的全球战略。PrEP于2020年在英国投入使用,是实现这些目标的基础,然而,在某些人群中,意识和摄取并不理想。
方法:伦敦性健康(SHL)在其电子分诊问卷中纳入了问题,该问卷估计了在线服务用户对PrEP的需求。向用户显示了两种类型的路标信息,指导他们访问更详细的在线内容:PrEP讨论(潜在需要)和PrEP符合条件(假定需要)。通过审查返回用户的人口统计和分类响应来评估此路标的有效性。
结果:426,149名SHL用户要求在1.7.21-31.10.22之间进行性传播感染筛查。16%(69,867/426,149)和32.2%(137,489/426,149)的个人获得了符合PrEP资格和PrEP讨论路标。符合PrEP资格的队列是:41.0%的同性恋/双性恋或其他与男性发生性关系的男性(GBMSM),16.3%异性恋男性,33.1%异性恋女性,白人占60.6%。PrEP讨论队列为:9.3%GBMSM,34.3%异性恋男性,45.5%的异性恋女性和63.7%的白人种族。50.4%(35,190/69,867)和41.3%(56,808/137,489)的符合PrEP资格和PrEP讨论队列订购了随后的SHLSTI测试套件,在此期间,10.0%(3510/35,190)和5.9%(3364/56,808)报告服用了PrEP。在那些否认服用PrEP的人中,59%(18702/31680)和61.0%(32559/53444)再次触发了PrEP路标。95.4%的PrEP初学者是GBMSM(6562/6874)和1.4%(97/6874)的异性恋男性/女性。
结论:电子服务证明了在估计PrEP需求和路标服务用户方面的可行性。随后,多达16%的返回用户开始了PrEP。这凸显了剩余在线用户的重大错失机会,他们继续报告艾滋病毒感染风险。区域/国家进一步努力优化PrEP的吸收,特别是在代表性不足的群体中,这是必要的。
BACKGROUND: The UK pledged commitment to the global strategy of zero new HIV infections and HIV-related deaths by 2030. PrEP was commissioned in England in 2020 and is fundamental to achieving these targets, yet awareness and uptake are suboptimal in certain populations.
METHODS: Sexual Health London (SHL) incorporated questions on its e-triage questionnaire estimating need for PrEP amongst online service users. Two types of signposting messaging were shown to users directing them to more detailed online content: PrEP-discussion (potential need) and PrEP-eligible (assumed need). The effectiveness of this signposting was evaluated by reviewing demographics and triage responses in returning users.
RESULTS: 426,149 SHL users requested STI screening between 1.7.21-31.10.22. 16% (69,867/426,149) and 32.2% (137,489/426,149) of individuals received PrEP-eligible and PrEP-discussion signposting. The PrEP-eligible cohort were: 41.0% gay/bisexual or other men who have sex with men (GBMSM), 16.3% heterosexual males, 33.1% heterosexual females, and 60.6% were of white ethnicity. The PrEP-discussion cohort were: 9.3% GBMSM, 34.3%% heterosexual males, 45.5% heterosexual females and 63.7% of white ethnicity. 50.4% (35,190/69,867) and 41.3% (56,808/137,489) of the PrEP-eligible and PrEP discussion cohorts ordered a subsequent SHL STI testing kit, during which 10.0% (3510/35,190) and 5.9% (3364/56,808) reported taking PrEP. Of those who denied taking PrEP, 59% (18,702/31,680) and 61.0% (32,559/53,444) triggered PrEP signposting again. 95.4% of PrEP starters were GBMSM (6562/6874) and 1.4% (97/6874) heterosexual males/females.
CONCLUSIONS: The e-service demonstrated feasibility in estimating PrEP need and signposting service users. Up to 16% of returning users subsequently commenced PrEP. This highlights significant missed opportunities for the remaining online users, who continue to report HIV acquisition risk(s). Further efforts regionally/nationally to optimise uptake of PrEP, particularly among under-represented groups are warranted.