Condom-Use Decision Making in the Context of Hypothetical Pre-Exposure Prophylaxis Efficacy Among Substance-Using Men Who Have Sex With Men: Project MIX
Condom-Use Decision Making in the Context of Hypothetical Pre-Exposure Prophylaxis Efficacy Among Substance-Using Men Who Have Sex With Men: Project MIX
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DOI：
10.1097/qai.0b013e31822b76d2
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发表时间：
2011-11-01
影响因子：
3.6
通讯作者：
Colfax, Grant N.
中科院分区：
文献类型：
--
作者：
Koblin, Beryl A.;Mansergh, Gordon;Colfax, Grant N.
目的：在暴露前预防假设性行为(PrEP)效果的背景下，考察与酒精及其他物质发生性行为的男性的避孕套使用决策。方法：在美国4个城市招募使用药物的男性进行行为干预试验。三组被定义如下：表示在使用PrEP时不使用安全套进行接受性/插入式无保护肛交(UAI)的男性，PrEP需要：(1)“几乎总是或总是”有效(高效率)；(2)“至少一半或更多时间有效，但不是几乎总是或总是有效”(根据最近的PrEP试验结果)；(3)有效“少于一半的时间”(低效)。结果：在630名从未使用PrEP的男性中，接受型UAI的中效组占15.2%，插入型UAI的中效组占34.1%。与接受性和插入性UAI的其他组相比，中等疗效组的安全性行为沟通困难的得分虽然很高，但显着高于其他两组。似乎通过肛交角色区分PrEP使用的男性在沟通困难方面得分较高，尽管在避孕套意向上得分较低。结论：在酒精或其他物质和避孕套意图的影响下进行关于安全性行为的沟通是PrEP使用者进行HIV预防干预的重要因素。
Objective: To examine condom-use decision making in the context of hypothetical pre-exposure prophylaxsis (PrEP) efficacy among men who have sex with men who use alcohol and other substances during sex.Methods: Substance-using men who have sex with men were recruited in 4 US cities for a behavioral intervention trial. Three groups were defined as follows: men who indicated that to not use a condom for receptive/insertive unprotected anal intercourse (UAI) while using PrEP, PrEP would need to be: (1) "almost always or always" effective (high efficacy); (2) effective "at least half the time or more but not almost always or always" (mid-range efficacy corresponding to recent PrEP trial results); (3) effective "less than half the time" (low efficacy). The mid-range efficacy group was compared with the low-efficacy group (as the reference) and to the-high efficacy group (as the reference).Results: Among 630 men who never used PrEP, 15.2% were in the mid-range efficacy group for receptive UAI and 34.1% in the mid-range efficacy group for insertive UAI. Scores on difficulty communicating about safer sex while high were significantly higher in the mid-range efficacy group compared with each of the other groups for both receptive and insertive UAI. Men who seemed to be differentiating PrEP use by anal sex role also scored higher on communication difficulties, although scoring lower on condom intentions.Conclusions: Communication about safer sex while under the influence of alcohol or other substances and condom intentions are important factors to consider for HIV prevention interventions for PrEP users.