"That's kind of like the big struggle right now is can we get PrEP?": Facilitators and Barriers to PrEP Uptake Among Active Duty Gay and Bisexual Men.
"That's kind of like the big struggle right now is can we get PrEP?": Facilitators and Barriers to PrEP Uptake Among Active Duty Gay and Bisexual Men.
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DOI：
10.1007/s13178-021-00622-6
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发表时间：
2023
影响因子：
2.6
通讯作者：
Holloway, Ian W
中科院分区：
文献类型：
--
作者：
Beltran, Raiza M;Schuyler, Ashley C;Blair, Cherie S;Goldbach, Jeremy T;Castro, Carl A;Holloway, Ian W
美国军方正在经历同性恋和双性恋男性（GBM）中艾滋病毒感染的上升，但对这一人群接受暴露前预防（PrEP）的情况知之甚少，这是一种基于证据的艾滋病毒预防干预措施。这项混合方法研究考察了现役GBM中PrEP获取和吸收的促进因素和障碍。现役GBM采用响应者驱动的抽样（2017年和2018年）招募。参与者（n = 93）回答了关于PrEP兴趣和可及性的定量调查问题。另一组参与者（n = 10）在定性访谈中讨论了他们的PrEP经验。我们对定量数据进行了描述性和双变量分析，而定性数据则使用结构和描述性编码技术进行分析。大约71%的现役GBM表示有兴趣访问PrEP。（vs.没有透露）他们的性取向，以他们的军医讨论（p < 0.001）或接近（p = 0.017）PrEP。出现了以下定性主题：（1）提供者对PrEP的负面看法和知识差距;（2）缺乏PrEP访问的系统方法;（3）保密问题;（4）依赖同行网络提供PrEP指导和支持。研究结果表明，现役GBM感兴趣，并希望与他们的军医讨论PrEP，但供应商的PrEP相关知识和技能的差距，以及对军队医疗保健系统的不信任，仍然存在。建议采用一种全系统的方法，解决保密问题，消除PrEP获取的程序障碍，以提高该人群的PrEP吸收率。
The US Military is experiencing a rise in HIV infections among gay and bisexual men (GBM) serving on active duty, yet little is known about this population’s uptake of pre-exposure prophylaxis (PrEP), an evidence-based intervention for HIV prevention. This mixed methods study examines the facilitators and barriers to PrEP access and uptake among active duty GBM. Active duty GBM were recruited using respondent-driven sampling (2017 and 2018). Participants (n = 93) answered quantitative survey questions on PrEP interest and accessibility. Another set of participants (n = 10) discussed their PrEP experiences in qualitative interviews. We conducted descriptive and bivariate analyses of quantitative data, while qualitative data were analyzed using structural and descriptive coding techniques. Approximately 71% of active duty GBM indicated interest in accessing PrEP. A greater proportion of those who disclosed (vs. did not disclose) their sexual orientation to their military doctor discussed (p < 0.001) or accessed (p = 0.017) PrEP. The following qualitative themes emerged: (1) providers’ negative views and knowledge gaps related to PrEP; (2) lack of a systems approach to PrEP access; (3) confidentiality concerns; and (4) reliance on peer networks for PrEP guidance and support. Study results indicate that active duty GBM are interested in and want to discuss PrEP with their military doctors, but gaps in providers’ PrEP-related knowledge and skills, as well as mistrust in the military health care system, remain. A system-wide approach that addresses confidentiality concerns and removes procedural barriers to PrEP access is recommended to improve PrEP uptake in this population.