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Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models

BACKGROUND: Pre-exposure prophylaxis (PrEP) is an effective and cost-effective strategy for HIV prevention. Spain carried out an implementation study in order to assess the feasibility of implementing PrEP programmes within its heterogeneous health system. METHODS: Observational longitudinal study c...

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Autores principales: Iniesta, Carlos, Coll, Pep, Barberá, María Jesús, García Deltoro, Miguel, Camino, Xabier, Fagúndez, Gabriela, Díaz, Asunción, Polo, Rosa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870089/
https://www.ncbi.nlm.nih.gov/pubmed/33556085
http://dx.doi.org/10.1371/journal.pone.0246129
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author Iniesta, Carlos
Coll, Pep
Barberá, María Jesús
García Deltoro, Miguel
Camino, Xabier
Fagúndez, Gabriela
Díaz, Asunción
Polo, Rosa
author_facet Iniesta, Carlos
Coll, Pep
Barberá, María Jesús
García Deltoro, Miguel
Camino, Xabier
Fagúndez, Gabriela
Díaz, Asunción
Polo, Rosa
author_sort Iniesta, Carlos
collection PubMed
description BACKGROUND: Pre-exposure prophylaxis (PrEP) is an effective and cost-effective strategy for HIV prevention. Spain carried out an implementation study in order to assess the feasibility of implementing PrEP programmes within its heterogeneous health system. METHODS: Observational longitudinal study conducted on four different types of health-care setting: a community centre (CC), a sexually transmitted infections clinic (STIC), a hospital-based HIV unit (HBHIVU) and a hospital-based STI unit (HBSTIU). We recruited gay, bisexual and other men who have sex with men (GBSM) and transgender women at risk of HIV infections, gave them PrEP and monitored clinical, behavioural PrEP-related and satisfaction information for 52 weeks. We collected perceptions on PrEP implementation feasibility from health-care professionals participating in the study. RESULTS: A total of 321 participants were recruited, with 99.1% being GBMSM. Overall retention was 87.2% and it was highest at the CC (92.6%). Condom use decreased during the study period, while STIs did not increase consistently. The percentage of people who did not miss any doses of PrEP during the previous week remained at over 93%. No HIV seroconversions occurred. We observed overall decreases in GHB (32.5% to 21.8%), cocaine (27.5% to 21.4%), MDMA (25.7% to 14.3%), speed (11.4% to 5.7%) and mephedrone use (10.7% to 5.0%). The overall participant satisfaction with PrEP was 98.6%. Health-care professionals’ perceptions of PrEP feasibility were positive, except for the lack of personnel. CONCLUSIONS: PrEP implementation is feasible in four types of health-care settings. Local specificities have to be taken into consideration while implementing PrEP.
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spelling pubmed-78700892021-02-11 Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models Iniesta, Carlos Coll, Pep Barberá, María Jesús García Deltoro, Miguel Camino, Xabier Fagúndez, Gabriela Díaz, Asunción Polo, Rosa PLoS One Research Article BACKGROUND: Pre-exposure prophylaxis (PrEP) is an effective and cost-effective strategy for HIV prevention. Spain carried out an implementation study in order to assess the feasibility of implementing PrEP programmes within its heterogeneous health system. METHODS: Observational longitudinal study conducted on four different types of health-care setting: a community centre (CC), a sexually transmitted infections clinic (STIC), a hospital-based HIV unit (HBHIVU) and a hospital-based STI unit (HBSTIU). We recruited gay, bisexual and other men who have sex with men (GBSM) and transgender women at risk of HIV infections, gave them PrEP and monitored clinical, behavioural PrEP-related and satisfaction information for 52 weeks. We collected perceptions on PrEP implementation feasibility from health-care professionals participating in the study. RESULTS: A total of 321 participants were recruited, with 99.1% being GBMSM. Overall retention was 87.2% and it was highest at the CC (92.6%). Condom use decreased during the study period, while STIs did not increase consistently. The percentage of people who did not miss any doses of PrEP during the previous week remained at over 93%. No HIV seroconversions occurred. We observed overall decreases in GHB (32.5% to 21.8%), cocaine (27.5% to 21.4%), MDMA (25.7% to 14.3%), speed (11.4% to 5.7%) and mephedrone use (10.7% to 5.0%). The overall participant satisfaction with PrEP was 98.6%. Health-care professionals’ perceptions of PrEP feasibility were positive, except for the lack of personnel. CONCLUSIONS: PrEP implementation is feasible in four types of health-care settings. Local specificities have to be taken into consideration while implementing PrEP. Public Library of Science 2021-02-08 /pmc/articles/PMC7870089/ /pubmed/33556085 http://dx.doi.org/10.1371/journal.pone.0246129 Text en © 2021 Iniesta et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Iniesta, Carlos
Coll, Pep
Barberá, María Jesús
García Deltoro, Miguel
Camino, Xabier
Fagúndez, Gabriela
Díaz, Asunción
Polo, Rosa
Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models
title Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models
title_full Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models
title_fullStr Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models
title_full_unstemmed Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models
title_short Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models
title_sort implementation of pre-exposure prophylaxis programme in spain. feasibility of four different delivery models
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870089/
https://www.ncbi.nlm.nih.gov/pubmed/33556085
http://dx.doi.org/10.1371/journal.pone.0246129
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