Preexposure Prophylaxis Modality Preferences Among Men Who Have Sex With Men and Use Social Media in the United States.
Preexposure Prophylaxis Modality Preferences Among Men Who Have Sex With Men and Use Social Media in the United States.
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DOI：
10.2196/jmir.5713
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发表时间：
2016-05-19
影响因子：
7.4
通讯作者：
Sullivan P
中科院分区：
文献类型：
--
作者：
Hall EW;Heneine W;Sanchez T;Sineath RC;Sullivan P
暴露前预防（PrEP）可作为预防人类免疫缺陷病毒（HIV）感染的每日药丸。正在讨论和开发全身或局部给予PrEP的创新方法。我们的研究的目的是评估对不同的实验方式的PrEP管理的态度。从2015年4月到7月，我们通过在线社交媒体广告招募了1106名艾滋病毒阴性男性，并调查了他们使用不同PrEP模式的可能性。参与者对5分Likert量表项目做出回应，表明他们使用以下每种PrEP方式的可能性：每日口服药丸，按需药丸，定期注射，阴茎凝胶（性交前或后），直肠凝胶（前/后）和直肠栓剂（前/后）。我们使用Wilcoxon符号秩检验来确定使用任何方式的可能性是否与每日口服PrEP不同。结合相关项目来评估基于组织或给药时间的使用可能性差异。参与者还对他们使用每种方式的兴趣进行了排名，我们使用了修改后的Borda计数方法来确定共识排名。大多数参与者表示，他们有可能或非常有可能使用PrEP作为按需药丸（685/1105，61.99%），每日口服药丸注射（575/1091，52.70%）或阴茎凝胶（438/755，58.01%）（性交前; 408/751，54.33%）。使用按需避孕药（中位数4）和性交前使用阴茎凝胶（中位数4）的可能性均高于使用每日口服避孕药（中位数4，分别为P <0.001和P = 0.001）。与每日口服药丸相比，参与者报告使用4种直肠方式中任何一种的可能性显着降低（Wilcoxon符号秩检验，所有P <.001）。在通过组合应用方法创建的10分Likert量表上，报告的使用阴茎凝胶的可能性（中位数7）高于使用直肠凝胶的可能性（中位数6，P <.001），直肠凝胶的可能性高于使用直肠栓剂的可能性（中位数6，P <.001）。修改后的Borda计数将按需药丸列为最受欢迎的方式。在性交前后使用PrEP（凝胶或栓剂）的可能性没有差异。参与者通常更喜欢全身性PrEP，并且不太可能使用直肠给药的方式。虽然大多数这些方式被认为是有利的或中立的，态度可能会改变有关的有效性和应用信息变得可用。关于风险群体之间模式偏好的进一步数据将更好地为PrEP的发展提供信息。
Preexposure prophylaxis (PrEP) is available as a daily pill for preventing infection with the human immunodeficiency virus (HIV). Innovative methods of administering PrEP systemically or topically are being discussed and developed. The objective of our study was to assess attitudes toward different experimental modalities of PrEP administration. From April to July 2015, we recruited 1106 HIV-negative men who have sex with men through online social media advertisements and surveyed them about their likelihood of using different PrEP modalities. Participants responded to 5-point Likert-scale items indicating how likely they were to use each of the following PrEP modalities: a daily oral pill, on-demand pills, periodic injection, penile gel (either before or after intercourse), rectal gel (before/after), and rectal suppository (before/after). We used Wilcoxon signed rank tests to determine whether the stated likelihood of using any modality differed from daily oral PrEP. Related items were combined to assess differences in likelihood of use based on tissue or time of administration. Participants also ranked their interest in using each modality, and we used the modified Borda count method to determine consensual rankings. Most participants indicated they would be somewhat likely or very likely to use PrEP as an on-demand pill (685/1105, 61.99%), daily oral pill (528/1036, 50.97%), injection (575/1091, 52.70%), or penile gel (438/755, 58.01% before intercourse; 408/751, 54.33% after). The stated likelihoods of using on-demand pills (median score 4) and of using a penile gel before intercourse (median 4) were both higher than that of using a daily oral pill (median 4, P<.001 and P=.001, respectively). Compared with a daily oral pill, participants reported a significantly lower likelihood of using any of the 4 rectal modalities (Wilcoxon signed rank test, all P<.001). On 10-point Likert scales created by combining application methods, the reported likelihood of using a penile gel (median 7) was higher than that of using a rectal gel (median 6, P<.001), which was higher than the likelihood of using a rectal suppository (median 6, P<.001). The modified Borda count ranked on-demand pills as the most preferred modality. There was no difference in likelihood of use of PrEP (gel or suppository) before or after intercourse. Participants typically prefer systemic PrEP and are less likely to use a modality that is administered rectally. Although most of these modalities are seen as favorable or neutral, attitudes may change as information about efficacy and application becomes available. Further data on modality preference across risk groups will better inform PrEP development.