An Emerging Substance Use Epidemic: Recreational Use of HIV Pre-Exposure Prophylaxis and Treatment in South Africa
An Emerging Substance Use Epidemic: Recreational Use of HIV Pre-Exposure Prophylaxis and Treatment in South Africa
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DOI：
10.1089/apc.2020.0218
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发表时间：
2021-03-01
影响因子：
4.9
通讯作者：
Mathews, Catherine
中科院分区：
文献类型：
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作者：
Kuo, Caroline;Dietrich, Janan;Mathews, Catherine
南非拥有世界上最大的艾滋病负担和治疗项目。将艾滋病毒预防和治疗药物转用于娱乐用途——或用于精神作用的非医疗用途——是全球和南非的一个公共卫生问题。南非很少有研究调查娱乐性使用艾滋病毒抗逆转录病毒药物（ARVs）。本文的目的是评估娱乐性抗逆转录病毒药物使用的流行程度，并确定与使用相关的风险和保护因素。数据来自对南非6个地区的N = 4399名15-24岁少女和年轻妇女（AGYW）进行的横断面家庭调查，这些地区对南非女孩和年轻妇女联合预防艾滋病毒进行了评估。据报告，所有地区使用抗逆转录病毒药物“获得快感”的情况占年复合增长率的8.3%。Logistic回归分析显示，从事交易性行为者娱乐性使用抗逆转录病毒药物的几率高出两倍[校正优势比(aOR) = 2.01；置信区间（95% CI）： 1.51-2.68]。使用暴露前预防（PrEP）的患者更有可能使用娱乐性抗逆转录病毒药物（aOR = 2.17; 95% CI: 1.36-3.48）；未接受抗逆转录病毒药物治疗的hiv阳性参与者（aOR = 0.36; 95% CI: 0.18-0.68）；以及病毒未被抑制者（aOR, no vs. yes = 2.84; 95% CI: 1.21-6.66）。随着抗逆转录病毒药物越来越广泛地用于预防和治疗，重要的是监测和处理可能出现的误用或滥用抗逆转录病毒药物。
South Africa has the largest HIV burden and treatment program in the world. Diversion of HIV prevention and treatment medication for recreational use-or nonmedical use for psychoactive effects-is a public health concern globally and in South Africa. Few South African studies examine recreational use of HIV antiretrovirals (ARVs). The objective of this article is to evaluate the prevalence of recreational ARV use and to identify risk and protective factors associated with use. Data are drawn from a cross-sectional household survey of N = 4399 adolescent girls and young women (AGYW) aged 15-24 years in six districts across South Africa where an evaluation of a South African combination HIV prevention for girls and young women was implemented. The use of ARVs to "get high" was reported by 8.3% of AGYW across all districts. Logistic regressions showed that those engaging in transactional sex were at two times higher odds of recreational ARV use [adjusted odds ratio (aOR) = 2.01; confidence interval (95% CI): 1.51-2.68]. Recreational ARV use was more likely among those who used pre-exposure prophylaxis (PrEP) (aOR = 2.17; 95% CI: 1.36-3.48); HIV-positive participants who were not on ARVs for treatment (aOR = 0.36; 95% CI: 0.18-0.68); and those who were not virally suppressed (aOR, no vs. yes = 2.84; 95% CI: 1.21-6.66). As ARVs become more widely available for prevention and treatment, it will be important to monitor and address the possible emergence of ARVs as a substance for misuse or abuse.