A descriptive analysis of perceptions of HIV risk and worry about acquiring HIV among FEM-PrEP participants who seroconverted in Bondo, Kenya, and Pretoria, South Africa.
A descriptive analysis of perceptions of HIV risk and worry about acquiring HIV among FEM-PrEP participants who seroconverted in Bondo, Kenya, and Pretoria, South Africa.
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DOI：
10.7448/ias.17.3.19152
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发表时间：
2014-01-01
影响因子：
6
通讯作者：
Agot, Kawango
中科院分区：
文献类型：
--
作者：
Corneli, Amy L;McKenna, Kevin;Agot, Kawango
引言：风险认知是许多公共卫生行为改变理论的核心结构。认为自己有患病风险的人可能更有可能采取减少风险的行为;那些不觉得有风险的人可能不太可能采取减少风险的行为。在两个FEM-PrEP站点- Bondo，肯尼亚和比勒陀利亚，南非-血清转换的参与者中，我们探讨了感知艾滋病毒的风险和担心获得HIV前HIV infection.METHODS：FEM-PrEP是一个III期临床试验，每天一次，口服恩曲他滨和替诺福韦二异丙酯富马酸盐在撒哈拉以南非洲妇女预防艾滋病毒。我们询问所有参与者在接下来的四周内，在艾滋病毒检测之前，在登记时和季度随访时进行定量面对面访谈时，他们对艾滋病毒风险的感知。在血清转换的参与者中，我们计算了他们在最接近艾滋病毒感染之前进行的访问中的反应频率。此外，在血清转换的妇女中，我们在参与者的艾滋病毒诊断访问后的第1周，第4周和第8周进行了定性，半结构化访谈（SSI），以回顾性地探讨艾滋病毒担忧的感觉。应用主题分析被用来分析SSI data.RESULTS：在参与者谁血清转化在邦多和比勒陀利亚，52%的定量访谈中报告说，他们没有机会获得艾滋病毒在未来四周。我们从SSI叙述中确定了四个风险合理化过程。在“保护性行为”中，参与者描述了他们用于降低艾滋病毒风险的至少一种降低风险行为;这些行为使他们感到不易感染艾滋病毒，因此他们不担心感染病毒。在“保护性推理”中，参与者考虑了他们的艾滋病毒风险，但基于某些事件或信念，他们认为自己并不脆弱，因此不必担心感染艾滋病毒。在“认识到脆弱性”方面，参与者描述了担心感染艾滋病毒的原因，但表示没有采取或采取有限的行动来减少他们认为的脆弱性。与“没有合理化或行动”的参与者没有描述任何艾滋病毒的担忧或没有从事艾滋病毒风险降低behaviors.CONCLUSIONS：妇女谁是在获得艾滋病毒的巨大风险可能会低估他们的实际风险。然而，其他准确了解其艾滋病毒风险的人可能无法就其关切采取行动。艾滋病毒风险认知和风险合理化是在减少风险咨询中探讨的重要概念，以增加有艾滋病毒风险的妇女对艾滋病毒预防战略的使用。
INTRODUCTION: Risk perception is a core construct in many behaviour change theories in public health. Individuals who believe they are at risk of acquiring an illness may be more likely to engage in behaviours to reduce that risk; those who do not feel at risk may be unlikely to engage in risk reduction behaviours. Among participants who seroconverted in two FEM-PrEP sites - Bondo, Kenya, and Pretoria, South Africa - we explored perceived HIV risk and worry about acquiring HIV prior to HIV infection.METHODS: FEM-PrEP was a phase III clinical trial of once-daily, oral emtricitabine and tenofovir disoproxil fumarate for HIV prevention among women in sub-Saharan Africa. We asked all participants about their perceived HIV risk in the next four weeks, prior to HIV testing, during a quantitative face-to-face interview at enrolment and at quarterly follow-up visits. Among participants who seroconverted, we calculated the frequencies of their responses from the visit conducted closest to, but before, HIV acquisition. Also among women who seroconverted, we conducted qualitative, semi-structured interviews (SSIs) at weeks 1, 4 and 8 after participants' HIV diagnosis visit to retrospectively explore feelings of HIV worry. Applied thematic analysis was used to analyse the SSI data.RESULTS: Among participants who seroconverted in Bondo and Pretoria, 52% reported in the quantitative interview that they had no chance of acquiring HIV in the next four weeks. We identified four processes of risk rationalization from the SSI narratives. In "protective behaviour," participants described at least one risk reduction behaviour they used to reduce their HIV risk; these actions made them feel not vulnerable to HIV, and therefore they did not worry about acquiring the virus. In "protective reasoning," participants considered their HIV risk but rationalized, based on certain events or beliefs, that they were not vulnerable and therefore did not worry about getting HIV. In "recognition of vulnerability," participants described reasons for being worried about getting HIV but said no or limited action was taken to reduce their perceived vulnerability. Participants with "no rationalization or action" did not describe any HIV worry or did not engage in HIV risk reduction behaviours.CONCLUSIONS: Women who are at substantial risk of acquiring HIV may underestimate their actual risk. Yet, others who accurately understand their HIV risk may be unable to act on their concerns. Perceived HIV risk and risk rationalization are important concepts to explore in risk reduction counselling to increase the use of HIV prevention strategies among women at risk of HIV.