HIV sero disclosure among men who have sex with men and transgender women on HIV pre-exposure prophylaxis.
HIV sero disclosure among men who have sex with men and transgender women on HIV pre-exposure prophylaxis.
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接受艾滋病毒暴露前预防的男男性行为者和跨性别女性的艾滋病毒血清披露情况。
DOI：
10.1080/09540121.2017.1394437
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发表时间：
2018
期刊：
影响因子：
1.7
通讯作者：
ForTheiPrExStudyTeam
中科院分区：
文献类型：
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作者：
Hojilla,JCarlo;Mehrotra,Megha;Truong,Hong-HaM;Glidden,DavidV;Amico,KRivet;McMahan,Vanessa;Vlahov,David;Chariyalertsak,Suwat;Guanira,JuanVicente;Grant,RobertM;ForTheiPrExStudyTeam
HIV 暴露前预防 (PrEP) 可能会导致个人认为血清披露是不必要的。我们调查了参加 iPrEx 开放标签扩展 (OLE) 的全球男男性行为者 (MSM) 和变性女性 (TW) 中不披露和缺乏伴侣状况知识的普遍情况。我们通过拟合逻辑模型并使用边际标准化估计预测概率来计算患病率。未披露和缺乏了解伴侣状况的比例在泰国最高（分别为 73% 和 74%），在美国最低（分别为 23% 和 37%）。在调整后的分析中，PrEP 的使用与不披露或缺乏伴侣状态知识没有显着相关（p 值>0.05）。我们发现关系特征与这两种结果均显着相关。在临时性伴侣（调整后患病率[aPR] 1.54，[95%置信区间1.24-1.84]）和交易性伴侣（aPR 2.03，[1.44-2.62]）以及参与者在第一次性接触前仅几分钟或几小时认识的伴侣（aPR 1.62，[1.33-1.92]）中，不透露信息的比例较高。同样，参与者不太可能知道临时伴侣（aPR 1.50，[1.30–1.71]）、交易性伴侣（aPR 1.62，[1.30–1.95]）以及仅认识几天或几周（aPR 1.13，[0.99–1.27]）或几分钟或几小时（aPR 1.27， [1.11–1.42]）。我们的研究结果强调了二元因素在影响血清披露中的作用。需要与 PrEP 结合提供全面的风险降低咨询，解决关系特征，以帮助患者引导围绕 HIV 状况的讨论。
HIV pre-exposure prophyalxis (PrEP) might lead individuals to view serodisclosure as unnecessary. We examined the prevalence of non-disclosure and lack of knowledge of partner status in a global cohort of men who have sex with men (MSM) and transgender women (TW) enrolled in the iPrEx Open Label Extension (OLE). We calculated prevalence ratios by fitting a logistic model and estimating predicted probabilities using marginal standardization. Prevalence of non-disclosure and lack of knowledge of partner status were highest in Thailand (73% and 74%, respectively) and lowest in the USA (23% and 37%, respectively). In adjusted analyses, PrEP use was not significantly associated with non-disclosure or lack of knowledge of partner status (p-values>0.05). We found that relationship characteristics were significantly associated with both outcomes. Non-disclosure was higher among casual (adjusted prevalence ratio [aPR] 1.54, [95% confidence interval 1.24–1.84]) and transactional sex partners (aPR 2.03, [1.44–2.62]), and among partners whom participants have known only minutes or hours before their first sexual encounter (aPR 1.62, [1.33–1.92]). Similarly, participants were less likely to know the HIV status of casual partners (aPR 1.50, [1.30–1.71]), transactional sex partners (aPR 1.62, [1.30–1.95]), and those they have known for only days or weeks (aPR 1.13, [0.99–1.27]) or minutes or hours (aPR 1.27, [1.11–1.42]). Our findings underscore the role of dyadic factors in influencing serodisclosure. Comprehensive risk reduction counseling provided in conjunction with PrEP that address relationship characteristics are needed to help patients navigate discussions around HIV status.