從實證到政策制定－－愛滋病毒暴露前口服於防性投藥

From Evidence to Health Policy Making: Pre-Exposure Prophylaxis for HIV Prevention

暴露愛滋病毒前，使用預防性投藥（pre-exposure prophylaxis）及配合傳統的預防方法（保險套、篩檢與諮商以及性病治療），可以有效而安全的降低感染愛滋病毒。世界衛生組織（World Health Organization）於2015年建議，暴露病毒前施予預防性投藥，以作為全球愛滋病防治的重要措施之一。本篇文章介紹如何從透過系統性文獻查證，並採用實證醫學證據評比系統（Grading of Recommendations Assessment, Development and Evaluation, GRADE）及參考全球最新的臨床指引，在臺灣疾病管制署及台灣愛滋病學會共同支持下，公布「臺灣暴露前口服預防性投藥使用指引」，並且介紹護理運用專業影響力，影響愛滋防治政策的制定過程。

Pre-exposure prophylaxis (PrEP), in combination with traditional prevention strategies (such as condom use, voluntary HIV counseling and testing, and treatment for sexually transmitted infections), has been shown to effectively prevent HIV infection. As of September 2015, the World Health Organization recommends that people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention. This article introduces how to apply a systematic review using the methodology of Grading of Recommendations Assessment, Development and Evaluation (GRADE) to write clinical guidelines. With support from the Taiwan Centers for Disease Control, the Taiwan AIDS Society published clinical guidelines for oral pre-exposure prophylaxis in Taiwan. Nurses are responsible to apply evidence-based knowledge and to use their professional influence to shape health policies related to HIV prevention.