Prediction of Sex and the Potential Use of On-Demand PrEP Among Young Men Who Have Sex With Men in the United States.
Prediction of Sex and the Potential Use of On-Demand PrEP Among Young Men Who Have Sex With Men in the United States.
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在美国男男性行为的年轻男性中进行性预测以及按需 PrEP 的潜在用途。
DOI：
10.1097/qai.0000000000003202
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Hightow-Weidman,LisaB
中科院分区：
文献类型：
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作者：
Stamp,BryceF;Powers,KimberlyA;Horvath,KeithJ;Soberano,ZacharyR;Hosek,SybilG;Stocks,JacobB;Rosso,MatthewT;Hightow-Weidman,LisaB
背景：按需给药的暴露前预防（PrEP）需要准确预测的性别;然而，预测能力的年轻男子与男性发生性关系（YMSM）还没有characteristic.Setting：一个全国招募的前瞻性队列的YMSM年龄16 - 24 years. Methods：我们遵循了120 YMSM为8周，使用数字每日调查（DDS）来衡量参与和预测超过24小时的肛交，沿着安全套的使用和其他危险级别的情况。我们的主要结果，"不可预测的自发性接触"，被定义为肛门性接触，发生没有足够的先验知识（假设），使保护按需使用PrEP根据剂量指南。我们将这一结果操作为肛交接触，参与者表示：（1）在前一天的DDS上，在随后的24小时内发生性行为的可能性很低（不可预测），（2）在当天的DDS上，他提前≤ 2小时知道会发生性行为（自发）。结果：在研究期间，大约三分之一的肛交接触是不可预测和自发的，并且不会受到按需给药的保护（假设）。超过三分之二的参与者经历了这样的遭遇，几乎四分之三的行为是condomless. Conclusions：按需PrEP，以防止艾滋病毒的收购可能是许多YMSM的挑战。临床和公共卫生方法，考虑患者的预测能力，以及他们的剂量偏好，可能有助于优化选择和坚持PrEP给药策略。
Background:On-demand dosing of preexposure prophylaxis (PrEP) requires accurate prediction of sex; however, prediction abilities among young men who have sex with men (YMSM) have not been characterized.Setting:A nationally recruited prospective cohort of YMSM ages 16–24 years.Methods:We followed 120 YMSM for 8 weeks using digital daily surveys (DDSs) to measure engagement in and prediction of anal sex over 24 hours, along with condom use and other encounter-level circumstances. Our main outcome, an “unpredicted spontaneous encounter,” was defined as an anal sex encounter that occurred without sufficient prior knowledge to (hypothetically) enable protective on-demand PrEP use according to dosing guidelines. We operationalized this outcome as an anal sex encounter for which a participant indicated:(1) on the prior day's DDS that there was a low likelihood of sex occurring in the subsequent 24 hours (unpredicted) and (2) on the current day's DDS that he knew≤ 2 hours in advance that the encounter would occur (spontaneous).Results:Approximately one-third of all anal sex encounters during the study period were unpredicted and spontaneous and would not have been protected (hypothetically) by on-demand dosing. More than two-thirds of participants experienced such an encounter and almost three-quarters of all acts were condomless.Conclusions:On-demand PrEP to prevent HIV acquisition may be challenging for many YMSM. Clinical and public health approaches that account for patients' predictive abilities alongside their dosing preferences may help to optimize selection of and adherence to PrEP dosing strategies.