Willingness to Take PrEP and Potential for Risk Compensation Among Highly Sexually Active Gay and Bisexual Men.
Willingness to Take PrEP and Potential for Risk Compensation Among Highly Sexually Active Gay and Bisexual Men.
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DOI：
10.1007/s10461-015-1030-1
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发表时间：
2015-12
影响因子：
4.4
通讯作者：
Parsons JT
中科院分区：
文献类型：
--
作者：
Grov C;Whitfield TH;Rendina HJ;Ventuneac A;Parsons JT
作为暴露前预防(PrEP)的一种方法，每日一次的特鲁瓦达(恩曲他滨/替诺福韦)是最有希望消除新的艾滋病毒感染的生物医学干预措施之一；然而，由于流行/社交媒体越来越担心PrEP的使用将导致避孕套使用的减少(即风险补偿)，同性恋、双性恋和其他与男性发生性关系的男子的接受速度一直很慢。我们调查了206名性行为高度活跃的HIV阴性男同性恋者和双性恋者在使用PrEP意愿方面的人口统计学、行为和心理社会差异，以及PrEP对参与者避孕套使用的感知影响。近半数(46.1%)表示，如果PrEP免费提供，他们愿意服用。尽管愿意接受PrEP的男性(与其他人相比)报告的最近临时男性伴侣的数量相似(<；6周)，但他们最近接受无套肛交(CAS)的几率更高--也就是说，那些已经感染艾滋病毒的高危人群更愿意接受PrEP。年龄、种族/民族和收入都与服用PrEP的意愿无关，这表明在经历艾滋病毒发病率差异的亚群中，接受程度是平等的。有有限的证据表明，男性会冒险赔偿。在没有参与近期CAS的男性中，只有10%的人认为PrEP会导致他们开始患有CAS。最近没有进行艾滋病毒检测的男性也比其他人更有可能表示愿意服用PrEP。向不经常检测的男性提供PrEP可能有助于让他们更多地参与常规的艾滋病毒/性传播感染检测，并在患者和提供者之间建立围绕性健康的持续对话，以防止艾滋病毒感染。
Once-daily Truvada (Emtricitabine/Tenofovir) as a method of pre-exposure prophylaxis (PrEP) is one of the most promising biomedical interventions to eliminate new HIV infections; however, uptake among gay, bisexual, and other men who have sex with men has been slow amidst growing concern in popular/social media that PrEP use will result in reduced condom use (i.e., risk compensation). We investigated demographic, behavioral, and psychosocial differences in willingness to use PrEP as well as the perceived impact of PrEP on participants’ condom use in a sample of 206 highly sexually active HIV-negative gay and bisexual men. Nearly half (46.1 %) said they would be willing to take PrEP if it were provided at no cost. Although men willing to take PrEP (vs. others) reported similar numbers of recent casual male partners (<6 weeks), they had higher odds of recent receptive condomless anal sex (CAS)—i.e., those already at high risk of contracting HIV were more willing to take PrEP. Neither age, race/ethnicity, nor income were associated with willingness to take PrEP, suggesting equal acceptability among subpopulations that are experiencing disparities in HIV incidence. There was limited evidence to suggest men would risk compensate. Only 10 % of men who had not engaged in recent CAS felt that PrEP would result in them starting to have CAS. Men who had not tested for HIV recently were also significantly more likely than others to indicate willingness to take PrEP. Offering PrEP to men who test infrequently may serve to engage them more in routine HIV/STI testing and create a continued dialogue around sexual health between patient and provider in order to prevent HIV infection.