Examining the Longitudinal Predictive Relationship Between HIV Treatment Outcomes and Pre-exposure Prophylaxis Use by Serodiscordant Male Couples.
Examining the Longitudinal Predictive Relationship Between HIV Treatment Outcomes and Pre-exposure Prophylaxis Use by Serodiscordant Male Couples.
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DOI：
10.1097/qai.0000000000002522
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发表时间：
2021-01-01
期刊：
影响因子：
--
通讯作者：
Mimiaga MJ
中科院分区：
文献类型：
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作者：
Jin H;Biello K;Garofalo R;Lurie M;Sullivan PS;Stephenson R;Mimiaga MJ
男男性行为者感染艾滋病毒/艾滋病的比例过高，暴露前预防措施的出现为减少艾滋病毒传播风险提供了一项有效战略。研究表明，改善伴侣的健康促进行为会增加他们的伴侣采取更健康行为的可能性。我们研究了艾滋病毒血清不一致的男性伴侣之间有利的艾滋病毒治疗结果与当前PrEP使用之间的纵向关系。数据来自Project Stronger Together，这是一项随机对照试验，招募了来自佐治亚州亚特兰大、马萨诸塞州波士顿和伊利诺伊州芝加哥的血清不一致的男性夫妇。血清不一致的夫妇在基线、6、12、18和24个月时完成评估。我们分析了来自120名HIV血清不一致男性伴侣的纵向数据，以评估HIV阴性伴侣当前使用PrEP与其HIV阳性伴侣当前使用ART、ART依从性和病毒载量之间的关系，使用广义估计方程模型。不到一半的艾滋病毒阴性伴侣在基线时接受了PrEP，近三分之二的艾滋病毒阳性伴侣受到病毒抑制。与具有可检测病毒载量的伴侣的HIV阴性伴侣相比，具有不可检测病毒载量的伴侣的HIV阴性男性伴侣成为当前PrEP用户的几率更大。我们的研究强调，需要制定二分层次的干预措施，以改善艾滋病毒药物的使用/艾滋病毒血清不一致的男性夫妇的依从性。我们的研究结果还表明，二元水平的干预措施可能能够利用我们对伴侣如何影响彼此的健康促进行为的理解，来制定改善伴侣双方健康结果的计划。
Men who have sex with men are disproportionately burdened by HIV/AIDS, and the advent of pre-exposure prophylaxis (PrEP) has provided an effective strategy to reduce the risk of HIV transmission. Research has shown that improving one partner’s health-promoting behaviors increases the likelihood that their partner adopts healthier behaviors. We examined the longitudinal relationship between favorable HIV treatment outcomes with current PrEP use among HIV serodiscordant male partners. Data are from Project Stronger Together, a randomized controlled trial that recruited serodiscordant male couples from Atlanta, GA, Boston, MA, and Chicago, IL. Serodiscordant couples completed assessments at baseline, 6, 12, 18, and 24 months. We analyzed longitudinal data from 120 HIV serodiscordant male partners to assess the relationship between the HIV-negative partner’s current PrEP use and their HIV-positive partner’s current ART use, ART adherence, and viral load using generalized estimating equation models. Fewer than half of the HIV-negative partners were on PrEP at baseline and nearly two-thirds of their HIV-positive partners were virally suppressed. HIV-negative male partners who had partners with an undetectable viral load had greater odds of being a current PrEP user compared to HIV-negative partners with partners with a detectable viral load. Our study highlights the need develop dyad-level interventions to improve HIV medication use/adherence by HIV serodiscordant male couples. Our findings also suggest that dyad-level interventions may be able to leverage our understanding of how partners can influence each other’s health-promoting behaviors to develop programs that improve health outcomes for both partners.