Responding to critiques of the Canadian PrEP guidelines: Increasing equitable access through a nurse-led active-offer PrEP service (PrEP-RN)
Bibliographic record
Abstract
HIV pre-exposure prophylaxis (PrEP) is the use of HIV medications by HIV-negative persons to prevent HIV acquisition from future potential or known exposures to this virus. Multiple studies have demonstrated its efficacy in this regard. In 2017, to help increase the use of PrEP in Canada, clinical practice guidelines were published. These summarized the available literature and made recommendations for men who have sex with men (MSM), persons who engage in injection drugs use (IDU), and heterosexual persons. Recently, arguments were made to suggest that these guidelines are not inclusive of other minority populations in Canada, including persons of African, Caribbean, and Black (ACB) descent and Indigenous persons. In this article, we review these critiques, and overview our approach to risk assessments for PrEP. Specifically, we detail the clinical procedures of our nurse-led PrEP clinic in Ottawa (entitled PrEP-RN). Lastly, we present preliminary uptake data for PrEP-RN, and discuss their meaning.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.068 | 0.178 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.029 | 0.023 |
| Scholarly communication | 0.012 | 0.005 |
| Open science | 0.009 | 0.007 |
| Research integrity | 0.014 | 0.031 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".