Syndemics and the PrEP Cascade: Results from a Sample of Young Latino Men Who Have Sex with Men
Syndemics and the PrEP Cascade: Results from a Sample of Young Latino Men Who Have Sex with Men
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DOI：
10.1007/s10508-019-01470-7
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发表时间：
2020-01-01
影响因子：
3.8
通讯作者：
Safren, Steven A.
中科院分区：
文献类型：
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作者：
Blashill, Aaron J.;Brady, John P.;Safren, Steven A.
与男性发生性关系的年轻拉丁裔男子（MSM）是艾滋病毒感染的高危人群。暴露前预防（PrEP）是一种新的生物医学艾滋病毒预防工具，可能有助于减少拉丁美洲男男性行为者之间艾滋病毒发病率的差异。然而，PrEP的使用在拉丁裔男男性接触者中是非常低的，因此，确定沿着PrEP连续护理（“PrEP级联”）的障碍将提供如何最好地部署PrEP干预措施的见解。Syndemics理论是一个突出的框架，在艾滋病毒预防，但是，迄今为止，没有已知的研究已经将这一理论应用到PrEP。因此，目前的研究的目的是探讨syndemics和PrEP级联之间的关联，包括在何种程度上心理社会和结构syndemic结构相关的PrEP级联。参与者是151名居住在加州圣地亚哥的年轻拉丁裔MSM（M年龄= 24岁; SD = 3），他们完成了一系列在线自我报告措施。结果表明，高水平的综合指标和不同程度的参与整个PrEP级联。随着流行病指标的增加，PrEP级联的参与几率显着降低。心理社会和结构性疾病的因素占独特的差异在PrEP级联。结果强调，需要采取综合干预措施，解决心理和结构性障碍，以准备使用和持久性年轻的拉丁美洲男男性接触者。
Young Latino men who have sex with men (MSM) are a highly vulnerable population for HIV infection. Pre-exposure prophylaxis (PrEP) is a novel biomedical HIV prevention tool that may aid in reducing the disparity in HIV incidence among Latino MSM. However, PrEP use is disproportionally low among Latino MSM and, therefore, identifying barriers along the PrEP continuum of care (the "PrEP cascade") would provide insight into how to best deploy PrEP interventions. Syndemics theory is a prominent framework employed in HIV prevention; however, to date, no known studies have applied this theory to PrEP. Thus, the aim of the current study was to explore the association between syndemics and the PrEP cascade, including the degree to which psychosocial and structural syndemic constructs are related to the PrEP cascade. Participants were 151 young Latino MSM (M age = 24 years; SD = 3) residing in San Diego, California, who completed a battery of online self-report measures. Results indicated high levels of syndemic indicators and varying levels of engagement across the PrEP cascade. As syndemic indicators increased, the odds of engagement across the PrEP cascade were significantly lowered. Psychosocial and structural syndemic factors accounted for unique variance in the PrEP cascade. Results highlight the need for combination interventions that address both psychosocial and structural barriers to PrEP use and persistence among young Latino MSM.