Willingness to use and preferences for long-acting injectable PrEP among sexual and gender minority populations in the southern United States, 2021-2022: cross-sectional study.
Willingness to use and preferences for long-acting injectable PrEP among sexual and gender minority populations in the southern United States, 2021-2022: cross-sectional study.
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DOI：
10.1002/jia2.26077
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发表时间：
2023-03
影响因子：
6
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用于预防艾滋病毒的长效注射（LAI）暴露前预防（PrEP）于2021年获得美国食品和药物管理局批准。LAI PrEP比口服PrEP更有效。然而，目前尚不清楚美国最有艾滋病毒风险的群体是否会使用LAI PrEP。在美国南部艾滋病毒流行集中的性和性别少数（SGM）人群中，尚未报告使用LAI PrEP的意愿和对LAI与口服PrEP的偏好。我们的目标是评估美国南部SGM人群使用LAI PrEP的意愿和对口服与LAI PrEP的偏好，并评估人口统计学和性行为意愿的差异。我们对美国南部15-34岁的SGM人群（n = 583）进行了一项在线横断面调查。参与者报告了使用LAI PrEP的意愿以及LAI PrEP与每日口服PrEP的偏好。我们评估了LAI-PrEP相关结局和关键人口统计学和行为特征的双变量关联并调整了患病率。总体而言，68%的参与者（n = 393）报告愿意使用LAI PrEP，提供3个月的艾滋病毒保护。其中，大多数（n = 320，81%）表示，与每日口服药丸或无偏好相比，偏好使用LAI PrEP。愿意使用LAI PrEP在跨性别和非二元参与者以及在过去6个月内进行无避孕套肛交的参与者中更为常见。与非西班牙裔白色受试者相比，西班牙裔受试者更有可能报告愿意使用LAI PrEP，而非西班牙裔黑人受试者报告愿意使用LAI PrEP的可能性更低。在美国南部的SGM人群中，使用LAI PrEP的意愿很高，尽管基于人口统计学特征的意愿存在一些重要差异。受艾滋病毒流行影响不成比例的群体（如非西班牙裔黑人SGM人群）使用LAI PrEP的意愿下降，可能会加剧艾滋病毒发病率的现有差异。LAI PrEP是美国南部SGM人群中可接受的选择，但需要制定策略以确保公平实施。
Long‐acting injectable (LAI) pre‐exposure prophylaxis (PrEP) for HIV prevention was approved by the U.S. Food and Drug Administration in 2021. LAI PrEP is more effective than oral PrEP. However, it is not clear whether the groups most at risk of HIV in the United States will use LAI PrEP. Willingness to use LAI PrEP and preference for LAI versus oral PrEP has not been reported for sexual and gender minority (SGM) people in the southern United States, where the HIV epidemic is concentrated. Our goal was to assess willingness to use LAI PrEP and preference for oral versus LAI PrEP among SGM people in the southern United States and to assess differences in willingness by demographics and sexual behaviour. We conducted an online, cross‐sectional survey of SGM people aged 15–34 years in the southern United States (n = 583). Participants reported willingness to use LAI PrEP and preferences for LAI PrEP versus daily oral PrEP. We assessed bivariate associations and adjusted prevalence ratios for the LAI‐PrEP‐related outcomes and key demographic and behavioural characteristics. Overall, 68% of all participants (n = 393) reported being willing to use LAI PrEP that provides protection against HIV for 3 months. Of those, most (n = 320, 81%) indicated a preference for using LAI PrEP, compared to a daily oral pill or no preference. Willingness to use LAI PrEP was more common among transgender and non‐binary participants and participants who engaged in condomless anal intercourse in the last 6 months. Hispanic participants were more likely and non‐Hispanic Black participants were less likely to report willingness to use LAI PrEP compared to non‐Hispanic White participants. Willingness to use LAI PrEP was high among SGM people in the southern United States, although there were some important differences in willingness based on demographic characteristics. Decreased willingness to use LAI PrEP among groups who are disproportionately affected by the HIV epidemic, such as non‐Hispanic Black SGM people, could exacerbate existing disparities in HIV incidence. LAI PrEP is an acceptable option among SGM populations in the southern United States, but strategies will be needed to ensure equitable implementation.