Gay and bisexual men's awareness and knowledge of treatment as prevention: findings from the Momentum Health Study in Vancouver, Canada
Gay and bisexual men's awareness and knowledge of treatment as prevention: findings from the Momentum Health Study in Vancouver, Canada
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DOI：
10.7448/ias.18.1.20039
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发表时间：
2015-08-11
影响因子：
6
通讯作者：
Hogg, Robert S.
中科院分区：
文献类型：
--
作者：
Carter, Allison;Lachowsky, Nathan;Hogg, Robert S.
前言：对加拿大温哥华hiv阳性和hiv阴性的男同性恋、双性恋和其他男男性行为者（GBMSM）对治疗预防（TasP）的认识和知识进行了评估。方法：在动量健康研究中，通过受访者驱动抽样（RDS）对入组的GBMSM的基线横断面调查数据进行分析。TasP意识被定义为曾经与从未听说过“TasP”这个术语。多变量逻辑回归确定了TasP意识的协变量。在了解TasP的人中，通过检查自我感知的知识水平、风险认知和TasP的简短回答定义来探索男性对TasP的知识水平，如果确定了三个与TasP相关的组成部分（即艾滋病毒治疗、病毒抑制和预防传播），则将其编码为“完整”。还评估了信息来源。根据HIV感染状况和RDS进行分层分析。结果：在719名参与者中，23%为hiv阳性，68%为白种人，中位年龄为33岁（四分位间距（IQR） 26,47）。总体而言，46%的GBMSM患者因HIV感染状况而存在TasP的差异[69%的HIV阳性vs 41%的HIV阴性（p < 0.0001）]。在调整后的模型中：hiv阳性的GBMSM更有可能听说过TasP，如果他们出生在加拿大，失业，不使用派对毒品，CD4计数较高；如果他们是白人（相对于土著）、学生、受过高等教育、有固定伴侣和多个性伴侣，那么hiv阴性的GBMSM更有可能听说过TasP。在知道TasP的人群中，91%的hiv阳性和69%的hiv阴性的GBMSM （p < 0.0001）认为他们对TasP了解“很多”或“一般”；64%和41% （p = 0.002）的人认为HIV治疗使传播风险“大大降低”；21%和13% （p < 0.0001）表示“完整”的TasP定义。主要的信息来源是医生（44%）和社区机构（38%）对hiv阳性的GBMSM和hiv阴性的GBMSM，其次是同性恋媒体（34%）。结论：本研究中近一半的GBMSM报告听说过TasP，但只有14%的人表示完全理解这个概念。艾滋病毒状况以及关键的社会人口、行为和临床因素对TasP的认识和知识的差异，突出表明需要制定与不同的GBMSM社区相关的健康传播战略，以提高总体TasP健康素养。
Introduction: Awareness and knowledge of treatment as prevention (TasP) was assessed among HIV-positive and HIV-negative gay, bisexual and other men who have sex with men (GBMSM) in Vancouver, Canada.Methods: Baseline cross-sectional survey data were analyzed for GBMSM enrolled, via respondent-driven sampling (RDS), in the Momentum Health Study. TasP awareness was defined as ever versus never heard of the term "TasP.'' Multivariable logistic regression identified covariates of TasP awareness. Among those aware of TasP, men's level of knowledge of TasP was explored through an examination of self-perceived knowledge levels, risk perceptions and short-answer definitions of TasP which were coded as "complete'' if three TasP-related components were identified (i.e. HIV treatment, viral suppression and prevention of transmission). Information source was also assessed. Analyses were stratified by HIV status and RDS adjusted.Results: Of 719 participants, 23% were HIV-positive, 68% Caucasian and median age was 33 (Interquartile range (IQR) 26,47). Overall, 46% heard of TasP with differences by HIV status [69% HIV-positive vs. 41% HIV-negative GBMSM (p < 0.0001)]. In adjusted models: HIV-positive GBMSM were more likely to have heard of TasP if they were Canadian born, unemployed, not using party drugs and had higher CD4 counts; HIV-negative GBMSM were more likely to have heard of TasP if they were Caucasian (vs. Aboriginal), students, had higher education, a regular partner and multiple sexual partners. Among those aware of TasP 91% of HIV-positive and 69% of HIV-negative GBMSM (p < 0.0001) felt they knew "a lot'' or "a bit in general'' about TasP; 64 and 41% (p = 0.002) felt HIV treatment made the risk of transmission "a lot lower''; and 21 and 13% (p < 0.0001) demonstrated "complete'' TasP definitions. The leading information source was doctors (44%) for HIV-positive GBMSM and community agencies (38%) for HIV-negative GBMSM, followed by gay media for both populations (34%).Conclusions: Nearly half of GBMSM in this study reported having heard of TasP, yet only 14% demonstrated complete understanding of the concept. Variations in TasP awareness and knowledge by HIV status, and key socio-demographic, behavioural and clinical factors, highlight a need for health communication strategies relevant to diverse communities of GBMSM in order to advance overall TasP health literacy.