Perceived influence of alcohol consumption, substance use, and mental health on PrEP adherence and condom use among PrEP-prescribed gay, bisexual, and other men-who-have-sex-with-men: a qualitative investigation.
Perceived influence of alcohol consumption, substance use, and mental health on PrEP adherence and condom use among PrEP-prescribed gay, bisexual, and other men-who-have-sex-with-men: a qualitative investigation.
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DOI：
10.1186/s12889-022-14279-2
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发表时间：
2022-10-07
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
男同性恋、双性恋和其他男男性行为者（GBMSM）仍然不成比例地受到人类免疫缺陷病毒（HIV）的影响。尽管艾滋病毒暴露前预防（PrEP）提供了一种有效的手段来减少这一人群中的艾滋病毒事件，但口服PrEP预防艾滋病毒的成功取决于方案的坚持。在GBMSM中，酒精、药物使用和精神健康相关问题的高比例可能会阻碍prep的实施，然而，这方面的证据仍然喜忧参半。因此，本研究需要一项全面的定性调查，以探讨PrEP处方的GBMSM对酒精、物质使用和心理健康对PrEP依从性的影响的看法。作为一项以酒精、物质使用和精神健康为重点的随机对照干预试验形成阶段的一部分，我们从加拿大多伦多的两家PrEP诊所招募了PrEP处方的GBMSM（年龄≥18岁；PrEP处方≥3个月）。焦点小组讨论定性地探讨了与坚持PrEP治疗相关的感知优势和障碍；重点是酒精、药物使用和心理健康问题。在这些关切的背景下，还讨论了prep规定的GBMSM中使用避孕套的问题。共进行5个焦点组，35例GBMSM（4-10人/组，平均年龄42.4岁，白人= 71.4%）。尽管参与者自己普遍报告成功地坚持了他们的PrEP方案-由于强烈的，潜在的自我保健动机-他们认识到酒精，物质使用和心理健康对同龄人的依从性产生了有害影响。在这方面，只有当饮酒过量或与PrEP剂量暂时相关时，酒精和物质才会被视为减损依从性。明显的心理健康问题（例如，严重的抑郁症）也被视为阻碍依从性，尽管这些影响是细微的，并且被认为是因人而异的。无论是否使用预防措施，酒精和其他物质都与不戴避孕套的性行为有关，因此预防措施被视为保护艾滋病毒的“安全网”。“总的来说，研究结果表明，在存在酒精、药物使用和精神健康问题的情况下，坚持PrEP通常可以成功实现。”增强自我保健，并解决明显的成瘾和精神健康相关问题，可能会加强GBMSM的PrEP治疗。
Gay, bisexual, and other men-who-have-sex-with-men (GBMSM) continue to be disproportionately affected by Human Immunodeficiency Virus (HIV). Although HIV pre-exposure prophylaxis (PrEP) offers an effective means of reducing incident HIV among this population, the HIV-preventive success of oral-based PrEP is contingent upon regimen adherence. Elevated rates of alcohol-, substance use-, and mental health-related issues among GBMSM potentially hinder PrEP-taking efforts, however the evidence for this remains mixed. Accordingly, the present study entailed a comprehensive qualitative investigation to explore PrEP-prescribed GBMSM’s perceptions surrounding the influence of alcohol, substance use, and mental health on PrEP adherence. PrEP-prescribed GBMSM (age ≥ 18 years; prescribed PrEP for ≥ 3 months) were recruited from two PrEP-delivery clinics in Toronto, Canada for focus groups as part of the formative phase of an alcohol-, substance use-, and mental health-focused randomized controlled intervention trial. Focus group discussions qualitatively explored perceived strengths and barriers associated with adherence to PrEP treatment; with an emphasis on alcohol, substance use, and mental health concerns. Condom use among PrEP-prescribed GBMSM within the context of these concerns was also discussed. A total of five focus groups involving 35 GBMSM were conducted (4–10/group; mean age = 42.4; white = 71.4%). Although participants themselves generally reported successfully adhering to their PrEP regimens—resulting from a strong, underlying motivation for self-care—they recognized the detrimental impact that alcohol, substance use, and mental health had on adherence among their peers. In this regard, alcohol and substances were perceived as detracting from adherence only when consumption was excessive or temporally linked to PrEP dosing. Pronounced mental health issues (e.g., severe depression) were also seen as hindering adherence, although these effects were nuanced and perceived as person-dependent. Alcohol and substances were linked to condomless sex, regardless of PrEP use, and PrEP was therefore viewed as an HIV-protective ‘safety net.’ Overall, findings suggest that PrEP adherence can often be successfully achieved in the presence of alcohol-, substance use-, and mental health-related issues. Augmenting self-care, and addressing pronounced addictions- and mental health-related concerns, may enhance PrEP treatment among GBMSM.
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影响因子：
8.1
作者：
de Casterle, Bernadette Dierckx;Gastmans, Chris;Denier, Yvonne
通讯作者：
Denier, Yvonne
DOI：
10.14745/ccdr.v45i12a01
发表时间：
2019-12-05
期刊：
Canada communicable disease report = Releve des maladies transmissibles au Canada
影响因子：
--
作者：
Haddad, N;Robert, A;Archibald, C
通讯作者：
Archibald, C
影响因子：
4.4
作者：
Grov C;Rendina HJ;John SA;Parsons JT
通讯作者：
Parsons JT
DOI：
10.1093/cid/ciu266
发表时间：
2014-07
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Amico KR;Stirratt MJ
通讯作者：
Stirratt MJ
影响因子：
4.4
作者：
Colson, P. W.;Franks, J.;Hirsch-Moverman, Y.
通讯作者：
Hirsch-Moverman, Y.