Sexual Risk Behaviors and Acceptability of HIV Pre-Exposure Prophylaxis Among HIV-Negative Gay and Bisexual Men in Serodiscordant Relationships: A Mixed Methods Study
Sexual Risk Behaviors and Acceptability of HIV Pre-Exposure Prophylaxis Among HIV-Negative Gay and Bisexual Men in Serodiscordant Relationships: A Mixed Methods Study
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DOI：
10.1089/apc.2011.0283
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发表时间：
2012-02-01
影响因子：
4.9
通讯作者：
Barkley, Thomas W.
中科院分区：
文献类型：
--
作者：
Brooks, Ronald A.;Landovitz, Raphael J.;Barkley, Thomas W.
这项混合方法研究的目的是检查艾滋病毒血清不一致关系中的艾滋病毒阴性男同性恋和双性恋男性 (GBM) 目前的性危险行为、暴露前预防 (PrEP) 预防艾滋病毒的可接受性和潜在采用，以及采用暴露前预防 (PrEP) 的性行为意图。对 25 名处于血清不一致关系中的 HIV 阴性 GBM 的多种族/族裔样本完成了定性访谈和由访谈者进行的简短调查。使用修改后的扎根理论方法来确定与 PrEP 的可接受性和未来采用相关的关键主题。参与者报告说，他们的性行为使他们面临感染艾滋病毒的风险。参与者还报告了对 PrEP 的高度接受度以及采用 PrEP 预防艾滋病毒的意愿。解释未来采用 PrEP 的定性主题包括：(1) 使用非安全套艾滋病毒预防方法进行性行为的机会，(2) 防止艾滋病毒感染，以及 (3) 与艾滋病毒阳性伴侣发生性行为时减少焦虑。与未来采用 PrEP 相关，大多数 (64%) 参与者表示性危险行为可能会增加，大多数 (60%) 参与者还表示可能会减少或放弃使用安全套，这两者都与大型 iPrEx 研究的结果形成鲜明对比。这些发现表明，HIV 阴性 GBM 在血清不一致的关系中使用 PrEP 具有风险补偿的潜力。研究结果表明，PrEP 仅作为全面 HIV 预防策略的一部分提供，其中包括在提供 PrEP 过程中持续提供风险降低咨询，以帮助缓和风险补偿。
The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP. Participants reported engaging in sexual risk behaviors that place them at risk for HIV infection. Participants also reported a high level of acceptability for PrEP and willingness to adopt PrEP for HIV prevention. Qualitative themes explaining future PrEP adoption included: (1) the opportunity to engage in sex using a noncondom HIV prevention method, (2) protection from HIV infection, and (3) less anxiety when engaging in sex with an HIV-positive partner. Associated with the future adoption of PrEP, a majority (64%) of participants indicated the likelihood for an increase in sexual risk behaviors and a majority (60%) of participants also indicated the likelihood for a decrease or abandonment of condom use, both of which are in contrast to the findings from the large iPrEx study. These findings suggest that the use of PrEP by HIV-negative GBM in serodiscordant relationships carries with it the potential for risk compensation. The findings suggest that PrEP only be offered as part of a comprehensive HIV prevention strategy that includes ongoing risk reduction counseling in the delivery of PrEP to help moderate risk compensation.