HIV Pre-exposure Prophylaxis Use and Persistence among Black Ciswomen: "Women Need to Protect Themselves, Period".

HIV Pre-exposure Prophylaxis Use and Persistence among Black Ciswomen: "Women Need to Protect Themselves, Period".
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DOI:
10.1007/s40615-021-01020-9
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发表时间:
2022-06
影响因子:
3.9
通讯作者:
Ridgway JP
Ridgway JP
中科院分区:
医学4区
文献类型:
--
作者:
Pyra M;Johnson AK;Devlin S;Uvin AZ;Irby S;Stewart E;Blum C;Green M;Haider S;Hirschhorn LR;Ridgway JP

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在黑人顺位女性中,艾滋病毒发病率和PrEP使用方面的差异仍然存在。我们使用混合方法检验与PrEP持续性相关的因素。伊利诺伊州芝加哥的黑人顺式妇女在联邦合格的健康中心(FQHC)开出PrEP处方。我们使用电子健康数据来确定PrEP的持久性(在6个月时覆盖≥的天数比例为86%),并在Logistic回归中测试人口统计学和临床因素。我们采访了8名黑人顺势女性,他们是PrEP Persistence特意挑选的。在112名黑人顺势女性中,18%是坚持不懈的。在调整后的模型中,社区、访问原因(入会时)和入会年份与持久度显著相关。定性上,我们几乎没有发现费用或坚持作为障碍的证据;参与者报告社区意识较低,提供者的重要性,以及对使用PrEP时的耻辱、副作用和怀孕的担忧。虽然黑人顺式女性的坚持性很低,但患者往往根据感知的艾滋病毒风险做出决定。我们确定了未来干预中需要解决的现实障碍。
Disparities in HIV incidence and PrEP use among Black ciswomen remain. We examine factors associated with PrEP persistence using mixed methods. Black ciswomen in Chicago, IL, prescribed PrEP at a federally qualified health center (FQHC). We used electronic health data to determine PrEP persistence (Proportion of Days Covered ≥86% at 6 months) and tested demographic and clinical factors in logistic regressions. We interviewed eight Black ciswomen, purposefully selected by PrEP persistence. Among 112 Black ciswomen, 18% were persistent. In adjusted models, neighborhood, visit reason (at initiation), and initiation year were significantly associated with persistence. Qualitatively, we found little evidence of cost or adherence as barriers; participants reported low community awareness, importance of providers, and concerns around stigma, side effects, and pregnancy while using PrEP. While persistence among Black ciswomen was low, patients were often making decisions based on perceived HIV risk. We identified real-world barriers to address in future interventions.
在性活跃的黑人妇女中使用预防前预防(PREP)的优势和缺点:一项探索性研究。
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