Dismantling Barriers and Transforming the Future of Pre-Exposure Prophylaxis Uptake in Young Black and Latinx Sexual Minority Men and Transgender Women.
Dismantling Barriers and Transforming the Future of Pre-Exposure Prophylaxis Uptake in Young Black and Latinx Sexual Minority Men and Transgender Women.
复制标题
消除障碍并改变年轻黑人和拉丁裔性少数男性和跨性别女性接受暴露前预防的未来。
DOI：
10.1089/apc.2021.0222
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发表时间：
2022
影响因子：
4.9
通讯作者：
Arrington-Sanders,Renata
中科院分区：
文献类型：
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作者：
Shorrock,Fiona;Alvarenga,Aubrey;Hailey-Fair,Kimberly;Vickroy,Wil;Cos,Travis;Kwait,Jennafer;Trexler,Constance;Wirtz,AndreaL;Galai,Noya;Beyrer,Chris;Celentano,David;Arrington-Sanders,Renata
暴露前预防（PrEP）有可能在年轻的黑人和拉丁裔性少数男性（SMM）和变性女性（TW）中转化艾滋病毒。解决这一人群中PrEP吸收率低的问题取决于对PrEP使用障碍的更好理解。本文采用生态框架，探讨在美国三个地理优先城市的年轻黑人和拉丁裔SMM和TW样本中每日口服PrEP的障碍。对33名年轻的黑人和拉丁裔SMM和TW（22名有艾滋病毒风险，11名最近被诊断为艾滋病毒）进行了深入访谈，年龄在17-24岁，参加了一项旨在增加PrEP和抗逆转录病毒治疗（ART）摄取和依从性的随机试验。访谈被记录和转录，然后使用归纳和演绎编码进行分析。编码的成绩单被组织成个人，人际，社区和结构类别，通过PrEP使用和艾滋病毒状态。在参与者中，有9人报告已服用PrEP，其中5人正在或最近服用PrEP，而只有一名被诊断患有艾滋病毒的参与者服用了PrEP。与个人、家庭、社区和结构层面的障碍相关的主要主题出现了。与合作伙伴有关的障碍有限，而感染艾滋病毒的合作伙伴鼓励使用PrEP。参与者普遍报告认为艾滋病毒的风险低，害怕披露，与保险/费用有关的障碍，以及药物使用的原因不使用PrEP。对于青年保持健康的生活过程中，艾滋病毒预防措施将需要在青春期早期采取艾滋病毒感染的风险。干预措施需要同时解决导致青少年不使用的多层次障碍。临床试验注册网站和编号：ClinicalTrials.gov标识符：NCT 03194477。
Pre-exposure prophylaxis (PrEP) has the potential to transform HIV in young Black and Latinx sexual minority men (SMM) and transgender women (TW). Addressing low PrEP uptake in this population depends on the better understanding of barriers to PrEP use. This article uses an ecological framework to explore barriers to daily oral PrEP in a sample of young Black and Latinx SMM and TW in three geographically prioritized cities in the United States. In-depth interviews were completed with 33 young Black and Latinx SMM and TW (22 at risk for and 11 recently diagnosed with HIV), aged 17–24, participating in a randomized trial aimed at increasing PrEP and antiretroviral therapy (ART) uptake and adherence. Interviews were recorded and transcribed, and then analyzed using inductive and deductive coding. Coded transcripts were organized into individual, interpersonal, community, and structural categories, by PrEP use and HIV status. Among participants, nine reported having been prescribed PrEP, with five actively or recently taking PrEP, whereas only one participant diagnosed with HIV had been prescribed PrEP. Major themes related to barriers emerged across the individual, family, community, and structural level. Limited barriers related to partners, instead partners with HIV encouraged PrEP use. Participants commonly reported low perceived HIV risk, fear of disclosure, barriers relating to insurance/cost, and medication use as reasons for nonuse of PrEP. For youth to remain on a healthy life course, HIV preventative measures will need to be adopted early in adolescence for those at risk of HIV acquisition. Interventions need to simultaneously address multilevel barriers that contribute to nonuse in adolescents. Clinical trials registry site and number: ClinicalTrials.gov Identifier: NCT03194477.