Preexposure antiretroviral prophylaxis attitudes in high-risk Boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education.
Preexposure antiretroviral prophylaxis attitudes in high-risk Boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education.
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DOI：
10.1097/qai.0b013e31818d5a27
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发表时间：
2009-01-01
期刊：
影响因子：
--
通讯作者：
Mayer KH
中科院分区：
文献类型：
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作者：
Mimiaga MJ;Case P;Johnson CV;Safren SA;Mayer KH
暴露前预防(PrEP)可以保护反复从事高危行为的个人免受艾滋病毒感染。了解使用PrEP的人口统计学和行为学预测因素可能有助于确定临床试验参与者。2007年，通过改良受访者驱动抽样招募的227名未感染艾滋病毒的男男性行为者完成了一项面试者管理的调查，评估了以前使用PrEP的情况和意识、未来使用PrEP的意图、人口统计学、性风险、心理社会变量以及药物/酒精使用。双变量和多变量Logistic回归程序检验了使用PrEP的意向的预测因素。参与者的平均年龄为41岁(SD=9.1)；54%是非白人。一名参与者报告了以前使用过非标签PrEP(从他感染艾滋病毒的兄弟那里获得的药物)。19%的人以前听说过PrEP，而74%的人报告说，在了解PrEP的潜力后，如果有的话，他们打算使用PrEP。在控制年龄和种族/民族的多变量分析中，有意义的预测因素包括：受教育程度低(OR=7.7p=0.04)、中等收入(OR=13.0；p=0.04)、服用PrEP无明显副作用(OR=3.5p=0.001)、不用为PrEP付费(OR=4.2p=0.05)。许多新英格兰MSM在了解PrEP的潜力后表示有兴趣使用PrEP，特别是如果他们可以免费获得PrEP，并且PrEP没有副作用。受教育程度较低的MSM和那些在进入研究之前对PrEP和抗逆转录病毒疗法(ART)了解较少的人，一旦收到一些表明其潜在价值的信息，就更愿意使用ART进行预防。研究结果表明，如果临床试验显示部分疗效，仔细的教育信息是必要的，以确保适当的PrEP使用。
Pre-exposure prophylaxis (PrEP) could protect individuals engaging in repeated high-risk behaviors from HIV infection. Understanding the demographic and behavioral predictors of intent to use PrEP may prove useful to identify clinical trial participants. In 2007, 227 HIV-uninfected MSM recruited through modified respondent-driven sampling completed an interviewer-administered survey assessing prior PrEP use and awareness, future intent to use PrEP, demographics, sexual risk, psychosocial variables, and drug/alcohol use. Bivariate and multivariable logistic regression procedures examined predictors of intention to use PrEP. Mean age of participants was 41 (SD=9.1); 54% were non-white. One participant reported prior off-label PrEP use (medication obtained from his HIV-infected brother). Nineteen percent had previously heard of PrEP, while 74% reported intent to use PrEP if available after being educated about its potential. In multivariable analysis controlling for age and race/ethnicity, significant predictors of intent to use PrEP included: less education (OR=7.7; p=0.04), moderate income (OR=13.0; p=0.04), no perceived side effects from taking PrEP (OR=3.5; p=0.001), and not having to pay for PrEP (OR=4.2; p=0.05). Many New England MSM indicated an interest in using PrEP after learning about its potential, particularly if they could obtain PrEP at no expense and if PrEP had no side effects. Less educated MSM and those who knew less about PrEP and antiretroviral therapy (ART) before entering the study were more open to using ART for prevention once they had received some information suggesting its potential value. Findings suggest careful educational messages are necessary to ensure appropriate PrEP use if clinical trials reveal partial efficacy.