I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation
I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation
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DOI：
10.1089/apc.2015.0259
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发表时间：
2016-02-01
影响因子：
4.9
通讯作者：
Baeten, Jared M.
中科院分区：
文献类型：
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作者：
Ngure, Kenneth;Heffron, Renee;Baeten, Jared M.
暴露前预防（PrEP）对未感染艾滋病毒的人是非常有效的艾滋病毒预防。了解艾滋病毒风险人群如何使用PrEP对于PrEP的扩大和实施非常重要。我们使用定性方法来收集对伴侣示范项目中使用PrEP的早期经验的见解，该项目是一项开放标签实施研究，旨在评估PrEP和抗逆转录病毒治疗（ART）的综合提供。向未感染艾滋病毒的伴侣提供PrEP，直到感染艾滋病毒的伴侣开始并持续使用ART（即，PrEP作为ART启动和病毒抑制的桥梁）。从2013年8月至2014年3月，我们进行了20次深入的二元访谈（n=40）与异性恋艾滋病毒血清不一致的夫妇参加蒂卡，肯尼亚的研究地点，探讨夫妇如何决定使用PrEP预防艾滋病毒。我们开发和应用演绎和归纳代码，以确定关键主题的经验，准备启动和使用有时限的PrEP.Couples报告说，准备为他们提供了一个额外的策略，以减少艾滋病毒传播的风险，满足他们的生育愿望，并科普艾滋病毒血清不一致。在随访中保持艾滋病毒阴性强化了夫妇的决定，并促使他们继续坚持PrEP。对提供者的建议和客户友好型服务的信心对他们决定开始和继续使用PrEP至关重要。在低资源环境下，为艾滋病毒血清不一致的夫妇提供大规模的PrEP服务可能包括建设卫生服务提供者的能力，以便在解决PrEP采用问题的同时，夫妇的关切以及收养和继续使用的障碍。
Pre-exposure prophylaxis (PrEP) for HIV-uninfected persons is highly efficacious for HIV prevention. Understanding how people at risk for HIV will use PrEP is important to inform PrEP scale-up and implementation. We used qualitative methods to gather insights into couples' early experiences with PrEP use within the Partners Demonstration Project, an open-label implementation study evaluating integrated delivery of PrEP and antiretroviral therapy (ART). PrEP is offered to HIV uninfected partners until the HIV-infected partner initiates and sustains ART use (i.e., PrEP as a bridge to ART initiation and viral suppression). From August 2013 to March 2014 we conducted 20 in-depth dyadic interviews (n=40) with heterosexual HIV serodiscordant couples participating at the Thika, Kenya study site, exploring how couples make decisions about using PrEP for HIV prevention. We developed and applied deductive and inductive codes to identify key themes related to experiences of PrEP initiation and use of time-limited PrEP. Couples reported that PrEP offered them an additional strategy to reduce the risk of HIV transmission, meet their fertility desires, and cope with HIV serodiscordance. Remaining HIV negative at follow-up visits reinforced couples' decisions and motivated continued adherence to PrEP. In addition, confidence in their provider's advice and client-friendly services were critical to their decisions to initiate and continue use of PrEP. Strategies for wide-scale PrEP delivery for HIV serodiscordant couples in low resource settings may include building capacity of health providers to counsel on PrEP adoption while addressing couples' concerns and barriers to adoption and continued use.