Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.
Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.
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DOI：
10.1186/s12954-017-0166-x
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发表时间：
2017-06-29
影响因子：
4.4
通讯作者：
Braunstein S
中科院分区：
文献类型：
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作者：
Walters SM;Reilly KH;Neaigus A;Braunstein S
由于生物、行为和结构因素，注射毒品(WWID)妇女感染艾滋病毒的风险更高。暴露前预防(PrEP)可以帮助WWID预防艾滋病毒。然而，对PrEP的WWID认知知之甚少，这是在PrEP被吸收之前必须发生的必要步骤。我们报告与WWID中更高意识相关的因素，以确定有效的意识传播手段。使用了在纽约市(NYC)收集的2015年全国艾滋病毒行为监测(NHBS)系统周期中关于注射毒品使用的数据。使用卡方统计进行双变量分析，以检验PrEP知晓率与社会人口统计、行为和卫生保健变量的相关性。多变量Logistic回归被用来估计调整后的关联性，并确定对PrEP的认识的差异。这项分析包括118个WWID。对PrEP知晓率较低(31%)，危险因素较高。在过去的12个月里，近三分之二(65%)的人报告了无套的性行为，大约三分之一(31%)的人报告了交易性行为，三分之一(32%)的人报告了共用注射设备。在多变量Logistic回归分析中，PrEP知晓率的提高与报告的交易性行为(AOR 3.32，95%CI 1.22-9.00)和在注射器交换计划(SEP)中进行关于HIV预防的对话(AOR 7.61，95%CI 2.65-21.84)相关。我们没有发现种族、教育、家庭收入、年龄、酗酒或性认同与PrEP意识显著相关。WWID中有很大一部分人不知道PrEP。这些发现表明，社交网络(特别是性工作和SEP网络)是传播有关预防材料(如PrEP)的信息的有效手段。我们建议增加SEP准入，在其他卫生保健环境中采用SEP流程，并利用WWID网络来提高PrEP意识。
Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22–9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65–21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.