The Context of Sexual Risk Behaviour Among Men Who Have Sex with Men Seeking PrEP, and the Impact of PrEP on Sexual Behaviour.
The Context of Sexual Risk Behaviour Among Men Who Have Sex with Men Seeking PrEP, and the Impact of PrEP on Sexual Behaviour.
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DOI：
10.1007/s10461-018-2300-5
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发表时间：
2019-07
影响因子：
4.4
通讯作者：
McCormack S
中科院分区：
文献类型：
--
作者：
Gafos M;Horne R;Nutland W;Bell G;Rae C;Wayal S;Rayment M;Clarke A;Schembri G;Gilson R;McOwan A;Sullivan A;Fox J;Apea V;Dewsnap C;Dolling D;White E;Brodnicki E;Wood G;Dunn D;McCormack S
在人们如何将预防艾滋病纳入现有的艾滋病毒预防战略方面，我们的理解仍然存在重大差距。在这篇论文中，我们利用这项引以为豪的研究中的定性数据，探索PrEP的使用如何影响现有的性风险行为和风险降低策略。从2014年2月到2016年1月，我们在英格兰的性健康诊所对参加骄傲PrEP研究的男同性恋者、双性恋者和其他男男性行为者(GBMSM)进行了41次深入采访。采访是用英语进行的，并被录音。对录音进行转录、编码，并使用框架分析进行分析。在采访中，我们探索了参与者在加入研究之前的性行为，以及在使用或曾经使用PrEP的人中，在开始PrEP后性行为的变化。参与者描述了在使用PrEP之前的风险行为和管理策略，其中包括不规律地使用避孕套、血清分类和战略定位。参与者描述了他们在启动PrEP之前的性风险，背景是毒品的性别化使用，与风险较高的性规范有关的地理空间，以及数字化的性网络，以及加剧风险承担的有问题的心理因素。研究结果表明，大体上，那些已经有过频繁无避孕套性行为的人，将PrEP添加到了现有的风险管理策略范围中，影响了一些人(但不是所有人)的“规则”的界限。虽然大约一半的参与者在开始PrEP后减少了其他风险降低策略，但另一半人没有改变他们的行为。由于其他预防方案的使用不一致，PREP为一群感染艾滋病毒风险较高的GBMSM提供了额外的艾滋病毒预防方案。总而言之，预防艾滋病毒方案提供了一个关键和必要的额外艾滋病毒预防选择，个人可以将其添加到现有战略中，以加强保护，至少是预防艾滋病毒。作为一种日常避孕药，PrEP在性文化的背景下提供保护，这些文化与性吸毒、数字化的性应用以及围绕性满足和冒险的社会规范的转变有关。PREP可以为个人提供短期或长期的选择，因为他们的性欲在他们的一生中发生变化，在高风险时期提供预防艾滋病毒的保护。PREP不应被视为或定位于与现有艾滋病毒预防工具包对立，而应被视为添加剂，并作为一种能够并正在对艾滋病毒产生重大影响的工具。
There are still important gaps in our understanding of how people will incorporate PrEP into their existing HIV prevention strategies. In this paper, we explore how PrEP use impacted existing sexual risk behaviours and risk reduction strategies using qualitative data from the PROUD study. From February 2014 to January 2016, we conducted 41 in-depth interviews with gay, bisexual and other men who have sex with men (GBMSM) enrolled in the PROUD PrEP study at sexual health clinics in England. The interviews were conducted in English and were audio-recorded. The recordings were transcribed, coded and analysed using framework analysis. In the interviews, we explored participants’ sexual behaviour before joining the study and among those using or who had used PrEP, changes to sexual behaviour after starting PrEP. Participants described the risk behaviour and management strategies before using PrEP, which included irregular condom use, sero-sorting, and strategic positioning. Participants described their sexual risk taking before initiating PrEP in the context of the sexualised use of drugs, geographical spaces linked with higher risk sexual norms, and digitised sexual networking, as well as problematic psychological factors that exacerbated risk taking. The findings highlight that in the main, individuals who were already having frequent condomless sex, added PrEP to the existing range of risk management strategies, influencing the boundaries of the ‘rules’ for some but not all. While approximately half the participants reduced other risk reduction strategies after starting PrEP, the other half did not alter their behaviours. PrEP provided an additional HIV prevention option to a cohort of GBMSM at high risk of HIV due to inconsistent use of other prevention options. In summary, PrEP provides a critical and necessary additional HIV prevention option that individuals can add to existing strategies in order to enhance protection, at least from HIV. As a daily pill, PrEP offers protection in the context of the sex cultures associated with sexualised drug use, digitised sexual applications and shifting social norms around sexual fulfilment and risk taking. PrEP can offer short or longer-term options for individuals as their sexual desires change over their life course offering protection from HIV during periods of heightened risk. PrEP should not be perceived or positioned in opposition to the existing HIV prevention toolkit, but rather as additive and as a tool that can and is having a substantial impact on HIV.
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DOI：
10.1097/qai.0b013e31828f097a
发表时间：
2013-09-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Liu AY;Vittinghoff E;Chillag K;Mayer K;Thompson M;Grohskopf L;Colfax G;Pathak S;Gvetadze R;Oʼhara B;Collins B;Ackers M;Paxton L;Buchbinder SP
通讯作者：
Buchbinder SP
影响因子：
12.7
作者：
Mustanski, Brian;Andrews, Rebecca;Schnarrs, Phillip W.
通讯作者：
Schnarrs, Phillip W.
影响因子：
3.7
作者：
Marcus JL;Glidden DV;Mayer KH;Liu AY;Buchbinder SP;Amico KR;McMahan V;Kallas EG;Montoya-Herrera O;Pilotto J;Grant RM
通讯作者：
Grant RM
影响因子：
4.9
作者：
Grace, Daniel;Jollimore, Jody;Tan, Darrell H. S.
通讯作者：
Tan, Darrell H. S.
影响因子：
4.4
作者：
Hammoud, Mohamed A.;Vaccher, Stefanie;Prestage, Garrett
通讯作者：
Prestage, Garrett