HIV Pre-Exposure Prophylaxis Stigma as a Multidimensional Barrier to Uptake Among Women Who Attend Planned Parenthood.
HIV Pre-Exposure Prophylaxis Stigma as a Multidimensional Barrier to Uptake Among Women Who Attend Planned Parenthood.
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DOI：
10.1097/qai.0000000000001762
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发表时间：
2018-09-01
期刊：
影响因子：
--
通讯作者：
Kershaw TS
中科院分区：
文献类型：
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作者：
Calabrese SK;Dovidio JF;Tekeste M;Taggart T;Galvao RW;Safon CB;Willie TC;Caldwell A;Kaplan C;Kershaw TS
PrEP的吸收在美国女性中落后。PrEP污名是MSM接受的一个公认障碍，但在女性中仍基本未被探索。这项研究探讨了PrEP污名在美国妇女中的普遍性及其对吸收的影响。在2017年对康涅狄格州新感染艾滋病毒人数最多的三个城市的计划生育患者进行的在线调查中，597名异性恋活跃，艾滋病毒阴性，没有经验的PrEP女性报告了背景特征，预期PrEP耻辱的两个方面（PrEP使用者的刻板印象和其他人对PrEP的反对），以及潜在PrEP吸收的三个指标（有兴趣了解更多关于PrEP，打算使用PrEP，并与提供者讨论PrEP）。参与者普遍认为PrEP使用者的刻板印象，许多人认为，如果他们使用PrEP，其他人会认为他们是滥交（37%），HIV阳性（32%），坏（14%）或同性恋（11%）。许多参与者预计家人（36%），性伴侣（34%）和朋友（25%）会反对。在调整后的分析中，PrEP用户刻板印象的感知与与提供者讨论PrEP的舒适度较低唯一相关。其他人预期的PrEP不赞成与PrEP兴趣较少，使用PrEP的意图较少以及与提供者讨论PrEP的舒适度较低有关。探索性适度分析表明，当参与者预期PrEP用户刻板印象和其他人不赞成PrEP的水平较低时，使用PrEP的意图最大。研究结果强调，需要针对潜在的PrEP用户及其社交网络进行积极的信息传递，以提高PrEP的接受度和吸收率。
PrEP uptake has lagged among US women. PrEP stigma is a recognized barrier to uptake among MSM but remains largely unexplored among women. This study examined the pervasiveness of PrEP stigma among US women and its implications for uptake. In a 2017 online survey of Planned Parenthood patients drawn from the three cities with the highest numbers of new HIV infections in Connecticut, 597 heterosexually-active, HIV-negative, PrEP-inexperienced women reported background characteristics, two dimensions of anticipated PrEP stigma (PrEP-user stereotypes and PrEP disapproval by others), and three indicators of potential PrEP uptake (interest in learning more about PrEP, intention to use PrEP, and comfort discussing PrEP with a provider). Participants commonly perceived PrEP-user stereotypes, with many believing that others would regard them as promiscuous (37%), HIV-positive (32%), bad (14%), or gay (11%) if they used PrEP. Thirty percent would feel ashamed to disclose PrEP use. Many participants expected disapproval by family (36%), sex partners (34%), and friends (25%). In adjusted analyses, perception of PrEP-user stereotypes was uniquely associated with lower comfort discussing PrEP with a provider. Expected PrEP disapproval by others was uniquely associated with less PrEP interest, less intention to use PrEP, and less comfort discussing PrEP with a provider. Exploratory moderation analyses suggested intention to use PrEP was greatest when participants anticipated low levels of both PrEP-user stereotypes and PrEP disapproval by others. Findings highlight the need for positive messaging targeting potential PrEP users and their social networks to increase PrEP acceptance and uptake.