Understanding Influences on Intention to Use Pre-exposure Prophylaxis (PrEP) Among African American Young Adults
Understanding Influences on Intention to Use Pre-exposure Prophylaxis (PrEP) Among African American Young Adults
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DOI：
10.1007/s40615-022-01278-7
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发表时间：
2022-03-15
影响因子：
3.9
通讯作者：
Sterrett-Hong, Emma
中科院分区：
文献类型：
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作者：
Ayangeakaa, Suur D.;Kerr, Jelani;Sterrett-Hong, Emma
暴露前预防（PrEP）是一种预防艾滋病毒的有效药物，有望缩小艾滋病毒感染的差距。然而，在美国，并不是所有种族和民族都公平地利用PrEP。非裔美国人对它的接受程度尤其低，他们受到艾滋病毒的影响尤为严重。了解除性别和性少数群体（如顺性异性恋者）以外的非裔美国年轻人的不同优先群体中PrEP使用率低的影响因素可能会增加PrEP的使用率。数据来自Afya项目，该项目以理性行动理论/计划行为理论（TRA/TPB）为理论框架，研究了在艾滋病毒风险较高的非洲裔美国年轻人的多个优先群体中使用PrEP预防艾滋病毒的情况。2018年6月至11月在肯塔基州路易斯维尔进行了11个焦点小组（N = 63），其中非裔美国青年成人优先群体（18-29岁）：男男性行为者、变性女性、顺性别异性恋男性和性风险较高的女性。数据分析采用建构主义扎根理论技术。PrEP的意识、知识、感知到的艾滋病毒风险和感知到的PrEP需求（行为信念）和依从性信念（控制信念）、他人的意见（主观规范）和对坚持PrEP能力的信心（感知到的行为控制）影响了PrEP的可接受性（参与者的态度），并反过来消极或积极地影响了使用PrEP的意图。因此，了解造成PrEP使用沉默的因素为针对非裔美国年轻人量身定制外展干预措施以提高PrEP的使用提供了有用的见解。
Pre-exposure prophylaxis (PrEP), a potent medication for HIV prevention, shows promise for reducing HIV disparities. However, PrEP is not equitably utilized by all races and ethnicities in the USA. Its uptake is especially low among African Americans, who are disproportionately impacted by HIV. Understanding factors influencing low PrEP uptake among diverse priority groups of African American young adults beyond gender and sexual minority groups (e.g., cisgender heterosexual people) may increase PrEP uptake. Data were from the Afya project, a study examining the use of PrEP for HIV prevention among multiple priority groups of African American young adults at heightened HIV risk, using Theory of Reasoned Action/Theory of Planned Behavior (TRA/TPB) as a theoretical framework. Eleven focus groups (N = 63) were conducted in Louisville, Kentucky from June to November 2018 with African American young adult priority groups (18-29 years old): men who have sex with men, transgender women, and cisgender heterosexual men and women demonstrating heightened sexual risk. Data were analyzed using constructivist grounded theory techniques. PrEP awareness, knowledge, perceived HIV risk and perceived need for PrEP (behavioral beliefs) and adherence beliefs (control beliefs), opinions of others (subjective norms), and confidence in ability to adhere to PrEP (perceived behavior controls) influenced acceptability of PrEP (participants' attitudes) and, in turn, influenced intention to use PrEP either negatively or positively. Thus, understanding factors that create reticence to PrEP use provides useful insight for tailoring outreach interventions towards African American young adults to improve PrEP uptake.