Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era
Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era
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DOI：
10.1089/apc.2015.0002
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发表时间：
2015-09-01
影响因子：
4.9
通讯作者：
Soto, Juliana K.
中科院分区：
文献类型：
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作者：
Mutchler, Matt G.;McDavitt, Bryce;Soto, Juliana K.
生物医学艾滋病毒预防战略，如暴露前预防(PrEP)和暴露后预防(PEP)，为降低青年黑人男男性行为者(YBMSM)极高的艾滋病毒感染率提供了新的机会。我们报告了在加利福尼亚州洛杉矶进行的24次二元定性访谈(N=48)的结果，探索YBMSM和他们的朋友如何看待PrEP和PEP。访谈采用扎根的理论方法进行分析。参与者对这些预防方法的知识水平差异很大。对PrEP的误解和不信任很常见，有人对PrEP相关的耻辱和可能认为PrEP上的人是艾滋病毒阳性的同龄人之间的八卦表示担忧。然而，参与者也将PrEP和PEP框定为艾滋病毒预防战略扩展的“工具包”中的有价值的新选项，这些战略为预防新的艾滋病毒感染创造了可能性，与不同艾滋病毒状况的男性约会，并减少了对暴露于艾滋病毒的焦虑。我们围绕四个主要领域组织了主题：(1)关于生物医学艾滋病毒预防的信息和错误信息；(2)对PrEP、性行为和耻辱的期望；(3)关于PrEP和PEP的八卦、披露和“传播消息”；以及(4)PrEP和PEP在扩展的艾滋病毒预防工具包中的作用。这些研究结果表明，在青年男性接触者可用的艾滋病毒预防选择的日益复杂的阵列中，需要提供指导。这样的“预防导航”可以消除误解，解决耻辱和不信任等障碍，同时帮助青年和青年男子从扩大的艾滋病毒预防选择中做出明智的选择。
Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded "tool kit" of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and "spreading the word" about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such "prevention navigation" could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options.