Belief in Treatment as Prevention and Its Relationship to HIV Status and Behavioral Risk.
Belief in Treatment as Prevention and Its Relationship to HIV Status and Behavioral Risk.
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DOI：
10.1097/qai.0000000000001557
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Moore DM
中科院分区：
文献类型：
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作者：
Card KG;Armstrong HL;Lachowsky NJ;Cui Z;Sereda P;Carter A;Montaner JSG;Hogg RS;Roth EA;Moore DM
我们评估了加拿大温哥华的同性恋、双性恋和其他男男性行为者（GBM）对治疗即预防（TasP）的态度。性活跃的GBM，年龄>16岁，在2012-2015年之间使用响应者驱动的抽样进行招募。在每六个月的随访中，参与者完成了一份计算机管理的问卷和护理访问。重复测量潜在类分析（RMLCA），分组自我报告的血清状态，确定模式的TasP认可考虑TasP相关的意识，态度和行为。二元逻辑回归确定类成员的协变量。双变量与访视次数的相互作用确定了与类别成员资格纵向变化相关的因素。774名男性提供了2，590个观察结果。其中，698例入组队列，575例至少接受了1次随访访视。其中，中位随访时间为1.98（Q1-Q2：1.49-2.49）年。RMLCA确定了三个类别：“不知道”（64.2%的艾滋病毒阴性/未知对29.2%的艾滋病毒阳性），“怀疑”（29.7%对23.1%）和“相信”（6.1%对47.7%）。代表较高TasP认可的班级成员与更大的无安全套肛交（CAS）和拥有更多性伴侣的几率相关。年龄、性取向、种族、物质使用和与其他GBM一起度过的社交时间也与阶级成员有关。纵向上，类成员是稳定的艾滋病毒阳性的男子，但转向更大的TasP的艾滋病毒阴性/未知的男子之间的认可。对于HIV阴性/未知的男性，越来越多的认可与更高的教育，就业，正在关系，和物质使用呈正相关，与最近的血清不一致的CAS或STI诊断呈负相关。随着时间的推移，艾滋病毒感染状况在TasP传播方面的差距有所缩小，但在其他主要社会阶层中继续存在。
We evaluated attitudes towards Treatment as Prevention (TasP) among gay, bisexual, and other men who have sex with men (GBM) in Vancouver, Canada. Sexually-active GBM, aged >16, were recruited between 2012–2015 using respondent-driven sampling. At each six-month follow-up, participants completed a computer-administered questionnaire and nursing visit. Repeated measures latent class analysis (RMLCA), grouped by self-reported serostatus, identified patterns of TasP-endorsement by considering TasP-related awareness, attitudes, and behavior. Binary logistic regression identified covariates of class membership. Bivariate interactions with visit number identified factors associated with longitudinal changes in class membership. 774 men provided 2,590 observations. Of these, 698 enrolled in the cohort, 575 had at least 1 follow-up visit. Among these, the median follow-up time was 1.98 (Q1-Q2: 1.49–2.49) years. RMLCA identified three classes: “Unaware” (64.2% HIV-negative/unknown versus 29.2% of HIV-positive), “Skeptical” (29.7% versus 23.1%), and “Believing” (6.1% versus 47.7%). Membership in classes representing higher TasP-endorsement was associated with greater odds of condomless anal sex (CAS) and having more sexual partners. Age, sexual orientation, ethnicity, substance use, and social time spent with other GBM were also associated with class membership. Longitudinally, class membership was stable among HIV-positive men, but shifted towards greater TasP-endorsement among HIV-negative/unknown men. For HIV-negative/unknown men, increasing endorsement was positively associated with greater education, being employed, being in a relationship, and substance use, and inversely associated with recent serodiscordant CAS or STI diagnosis. Over time, disparities in TasP diffusion by HIV status have lessened, though continue to persist across other key social strata.