Study objective

Many emergency departments (EDs) have identified the importance of HIV prevention and have implemented steps to screen and offer preexposure prophylaxis (PrEP). The objective of this study was to systematically review existing literature that identifies PrEP eligibility in the ED and summarize outcomes along the PrEP cascade of care (awareness, interest, linkage to treatment, initiation, and retention) for patients in ED.

Methods

Four databases captured all PrEP-related studies in EDs from January 1, 2013 to January 27, 2022. Data were extracted on study characteristics and outcomes, and study quality was assessed using a modified quality assessment tool by the Effective Public Health Practice Project.

Results

Of the 218 articles, 16 were subjected to full-text review, and 7 met inclusion criteria. Although most studies identified patients who were PrEP eligible using criteria adapted from the 2017 Centers for Disease Control and Prevention PrEP guidelines, the number and time frame for each criterion varied. Six studies reported outcomes on the PrEP cascade of care, showing a relatively high prevalence of awareness and interest but a very low prevalence of linkage and uptake. No studies documented retention in PrEP treatment.

Conclusion

Although up to a third of patients in ED assessed in the current study were PrEP eligible, less than half of PrEP-eligible participants had prior knowledge of PrEP, and very few who expressed interest in the ED were ultimately linked to PrEP treatment or initiated PrEP. Future research is necessary to identify strategies to increase PrEP education, interest, and linkage to care from the ED.

中文翻译：

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急诊科的 HIV 暴露前预防：系统评价

学习目标

许多急诊科 (ED) 已经确定了 HIV 预防的重要性，并已采取措施进行筛查并提供暴露前预防 (PrEP)。本研究的目的是系统地回顾现有文献，这些文献确定了 ED 中 PrEP 的资格，并总结了 ED 患者 PrEP 级联护理（意识、兴趣、与治疗的联系、启动和保留）的结果。

方法

四个数据库收集了从 2013 年 1 月 1 日到 2022 年 1 月 27 日在急诊室进行的所有 PrEP 相关研究。提取了有关研究特征和结果的数据，并使用有效公共卫生实践项目改进的质量评估工具评估了研究质量。

结果

在 218 篇文章中，16 篇进行了全文审查，7 篇符合纳入标准。尽管大多数研究使用改编自 2017 年疾病控制和预防中心 PrEP 指南的标准确定了符合 PrEP 资格的患者，但每个标准的数量和时间范围各不相同。六项研究报告了 PrEP 级联护理的结果，表明意识和兴趣的普遍性相对较高，但联系和吸收的普遍性非常低。没有研究记录 PrEP 治疗中的保留。

结论

尽管在当前研究中评估的 ED 患者中多达三分之一符合 PrEP 条件，但只有不到一半符合 PrEP 条件的参与者事先了解 PrEP，并且对 ED 表示兴趣的人中很少有人最终与 PrEP 治疗相关联或开始了 PrEP . 未来的研究有必要确定增加 PrEP 教育、兴趣和与急诊室护理联系的策略。