PEP Manuscript Tables and Figures 26.03.25.xlsx

<b>Introduction:</b> The World Health Organization (WHO) recently updated its guidelines for HIV post-exposure prophylaxis (PEP) (1). These guidelines recommend community delivery and task-sharing for PEP administration and suggest enhanced adherence counseling (2,3). This work provides insights into considerations for optimizing people’s knowledge, demand, use and adherence regarding PEP. This mixed-method study examined five research questions concerning perceptions and experiences of various groups regarding accessing and utilizing PEP and explored opinions on alternative delivery options to broaden access.<br><b>Methods</b>: We spoke with a total of 1,156 end-users: 236 through qualitative Focus Groups (FGs) and in-depth interviews (IDIs), and 920 surveyed via questionnaire in Kenya, Nigeria and Zimbabwe, including members of key populations (Female Sex Workers, Members of the LGBTQ+ Community, People Who Inject Drugs).<br><b>Results:</b> Prompted awareness of PEP varied across the study countries (56.2% overall). Healthcare providers (doctors and nurses) were cited by end-users as primary sources of information on HIV and PEP. PEP information evaluation revealed that condomless sex or condom malfunction were the emergency situations that resonated most with end-users. Most (86.4%) cited a perceived likelihood to use PEP if exposed to HIV. A general hospital was deemed most acceptable for PEP access by end-users in all countries (81.2%); clinical routes were preferable to alternative routes (such as vending machines or websites) for accessing PEP, with key reasons being convenience (68.2%), trustworthiness (56.5%) and knowledge (56.5%). End-users emphasized the need for consistent, correct, and supportive interaction points with healthcare providers to complete PEP treatment and follow-up.<br><b>Conclusions:</b> PEP uptake is dependent on confidentiality and privacy of services and on increasing awareness and knowledge of the PEP pathway. Provision of PEP needs to incorporate multiple end-user touch/access-points with emotional support for greater adherence, and our study highlights the different preferences and access contexts among end-users for PEP.

<b>引言:</b> 世界卫生组织（World Health Organization, WHO）近日更新了其艾滋病病毒暴露后预防（HIV post-exposure prophylaxis, PEP）相关指南[1]。新指南推荐采用社区递送模式与任务分担机制开展PEP给药，并建议强化依从性咨询[2,3]。本研究旨在深入探讨优化PEP相关认知、需求、使用行为及依从性的考量方向。本项混合方法研究针对不同群体获取与使用PEP的认知与体验提出了五个研究问题，并探讨了拓宽PEP可及性的替代递送方案相关意见。<br><b>研究方法:</b> 本研究共访谈调研了1156名目标使用者：其中236名通过定性焦点小组访谈（Focus Groups, FGs）与深度访谈（in-depth interviews, IDIs）开展调研，剩余920名则通过问卷调查完成数据收集，调研覆盖肯尼亚、尼日利亚与津巴布韦三国，受访对象包括各类关键人群：女性性工作者、LGBTQ+群体以及注射毒品使用者。<br><b>研究结果:</b> 本研究覆盖三国中，受试者对PEP的提示性知晓率存在差异，整体知晓率为56.2%。目标使用者表示，医护人员（医生与护士）是其获取艾滋病病毒与PEP相关信息的主要渠道。针对PEP相关信息的评估结果显示，无保护性行为或安全套破裂是最能引发目标使用者共鸣的艾滋病病毒暴露紧急场景。86.4%的受访者表示，若发生艾滋病病毒暴露，他们大概率会使用PEP。三国均有81.2%的目标使用者认为，综合医院是获取PEP的最可接受场所；相较于自动售货机、线上平台等替代途径，临床就诊途径更受青睐，主要原因包括便利性（68.2%）、可靠性（56.5%）与信息认知度（56.5%）。目标使用者强调，在完成PEP治疗与随访的过程中，需与医护人员保持连贯、准确且富有支持性的沟通互动。<br><b>研究结论:</b> PEP的使用情况取决于服务的保密性与隐私保护，以及提升目标人群对PEP全流程的知晓度与认知水平。PEP的提供需整合多样化的目标使用者服务接触点与获取渠道，并辅以情感支持以提升用药依从性；本研究同时凸显了不同目标使用者群体在PEP获取偏好与场景上的差异。