Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts.
Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts.
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DOI：
10.1080/09540121.2017.1300633
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发表时间：
2017-11
期刊：
影响因子：
1.7
通讯作者：
Mayer KH
中科院分区：
文献类型：
--
作者：
Cahill S;Taylor SW;Elsesser SA;Mena L;Hickson D;Mayer KH
男同性恋者、双性恋者和其他男男性行为者(MSM)占美国新增艾滋病毒感染人数的三分之二以上，其中黑人MSM的负担最大。抗逆转录病毒暴露前预防(PrEP)可以降低男男性行为者对艾滋病毒感染的易感性。对PrEP的接受一直很有限，特别是在种族和少数民族男男性接触者中。2013年底，由男同性恋者和双性恋者以及其他有感染艾滋病毒风险的MSM组成的四个半结构化焦点小组在波士顿和杰克逊召开。分析计划利用案例内、跨案例的方法来编码和分析新兴主题，并比较两个城市的结果。在杰克逊招募的参与者主要是黑人男同性恋，而波士顿的参与者大多是非西班牙裔白人男同性恋。这两个网站的参与者都对男同性恋者的药物副作用和文化上不敏感的医疗保健表示担忧。杰克逊的参与者描述了更强烈的医疗不信任，更频繁地描述了反同性恋和艾滋病毒相关耻辱的经历。描述了PrEP摄取的多个可寻址障碍。关于副作用的信息应在PrEP教育活动中明确提出。医疗服务提供者和卫生部门应解决医疗不信任问题，特别是黑人男同性恋者、双性恋者和其他男男性接触者之间的医疗不信任问题，部分方法是培训提供者如何提供肯定的、有文化能力的护理。密西西比州的医疗补助应该扩大到覆盖低收入的年轻黑人、同性恋和双性恋男性以及其他男男性接触者。
Gay and bisexual men and other men who have sex with men (MSM) account for more than two thirds of new HIV infections in the U.S., with Black MSM experiencing the greatest burden. Antiretroviral pre-exposure prophylaxis (PrEP) can reduce MSM's vulnerability to HIV infection. Uptake of PrEP has been limited, particularly among racial and ethnic minority MSM. Four semi-structured focus groups with gay and bisexual men and other MSM at risk for HIV infection were convened in Boston and Jackson in late 2013. The analysis plan utilized a within-case, across-case approach to code and analyze emerging themes, and to compare results across the two cities. Participants recruited in Jackson were primarily Black gay men, while Boston participants were mostly non-Hispanic White gay men. Participants in both sites shared concerns about medication side effects and culturally insensitive health care for gay men. Jackson participants described stronger medical mistrust, and more frequently described experiences of anti-gay and HIV related stigma. Multiple addressable barriers to PrEP uptake were described. Information about side effects should be explicitly addressed in PrEP education campaigns. Providers and health departments should address medical mistrust, especially among Black gay and bisexual men and other MSM, in part by training providers in how to provide affirming, culturally competent care. Medicaid should be expanded in Mississippi to cover low-income young Black gay and bisexual men and other MSM.
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影响因子：
12.7
作者：
Eaton LA;Driffin DD;Kegler C;Smith H;Conway-Washington C;White D;Cherry C
通讯作者：
Cherry C
影响因子：
12.7
作者：
Hatzenbuehler, Mark L.;O'Cleirigh, Conall;Bradford, Judith
通讯作者：
Bradford, Judith
影响因子：
120.7
作者：
Obedin-Maliver, Juno;Goldsmith, Elizabeth S.;Lunn, Mitchell R.
通讯作者：
Lunn, Mitchell R.
影响因子：
2
作者：
Sandelowski, Margarete
通讯作者：
Sandelowski, Margarete
影响因子：
1.7
作者：
Brooks RA;Kaplan RL;Lieber E;Landovitz RJ;Lee SJ;Leibowitz AA
通讯作者：
Leibowitz AA