Guidance for Providing Informed-Choice Counseling on Sexual Health for Women Interested in Pre-Exposure Prophylaxis in Kenya and South Africa.
Guidance for Providing Informed-Choice Counseling on Sexual Health for Women Interested in Pre-Exposure Prophylaxis in Kenya and South Africa.
复制标题
为肯尼亚和南非对暴露前预防感兴趣的妇女提供性健康知情选择咨询的指南。
DOI：
10.1089/apc.2015.0244
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发表时间：
2016
影响因子：
4.9
通讯作者：
Ahmed,Khatija
中科院分区：
文献类型：
--
作者：
Corneli,Amy;Yacobson,Irina;Agot,Kawango;Ahmed,Khatija
暴露前预防（通常称为 PrEP）是一种新的 HIV 预防方法，如果定期采取，可以显着降低个人感染 HIV 的风险。 1-3 随着新的艾滋病毒预防方法（尤其是高效的方法）的引入，需要咨询指导来帮助潜在用户确定新方法是否适合他们。还需要提供指导，帮助个人考虑新方法是否适合或不适合他们当前的风险降低行为（如果有）。为了最好地预防艾滋病毒，个人应将 PrEP 与其他预防措施结合使用，例如持续正确地使用安全套，以降低感染艾滋病毒的风险。然而，有些人可能对其部分或全部伴侣使用安全套的控制有限或无法控制，或者可能不希望使用安全套。因此，艾滋病毒预防咨询必须解决一些使用 PrEP 的人可能选择停止使用安全套或不太持续使用安全套的可能性，即使鼓励他们在使用 PrEP 时继续使用安全套。我们制定了咨询指南，促进肯尼亚和南非妇女就性健康做出知情决策，这些妇女表示有兴趣将 PrEP 作为其艾滋病毒风险降低战略的一部分，特别是在 (1) 有关 PrEP 和安全套使用的决定，以及 (2) 单独使用 PrEP 时预防怀孕和其他性传播感染方面。我们对 PrEP 的研究结果表明需要这样的指导。我们对肯尼亚邦多和南非比勒陀利亚的 799 名女性进行了一项调查，以了解如果她们开始服用 PrEP，她们的性行为（例如，使用安全套、与新伴侣发生性行为）是否以及如何改变或保持不变。在这些女性中，27-40% 的人表示，如果她们采取 PrEP，她们将倾向于根据风险情况减少使用其他 HIV 风险降低措施。 4
Pre-exposure prophylaxis—commonly referred to as PrEP—is a new HIV prevention method that significantly reduces an individual’s risk of acquiring HIV if taken regularly. 1–3 With the introduction of a new HIV prevention method—especially a highly effective one—counseling guidance is needed to help potential users determine if the new method is the right approach for them. Guidance is also necessary for helping individuals consider how the new method fits, or does not fit, with their current risk-reduction behaviors, if any. For the best protection against HIV, individuals would use PrEP together with other prevention measures, such as using condoms consistently and correctly, to reduce their risk of HIV. However, some individuals may have limited or no control over condom use with some or all of their partners, or may wish not to use condoms. HIV prevention counseling must therefore address the possibility that some individuals who use PrEP may choose to discontinue condom use or to use condoms less consistently, even if they are encouraged to continue condom use while using PrEP. We have developed counseling guidance that promotes informed decision making on sexual health for women in Kenya and South Africa who have expressed interest in using PrEP as part of their HIV risk-reduction strategy, particularly with respect to (1) decisions concerning PrEP and condom use, and (2) the prevention of pregnancy and other sexually transmitted infections when PrEP is used alone. Findings from our research on PrEP suggested such guidance would be needed.We conducted a survey among 799 women in Bondo, Kenya, and Pretoria, South Africa, to find out if and how their sexual behaviors (eg, condom use, having sex with a new partner) might change or stay the same if they were to start taking PrEP. Among these women, 27–40% indicated that they would be inclined to reduce their use of other HIV-risk reduction measures, depending on the context of the risk situation, if they took PrEP. 4