Black Cisgender Women's PrEP Knowledge, Attitudes, Preferences, and Experience in Chicago
Black Cisgender Women's PrEP Knowledge, Attitudes, Preferences, and Experience in Chicago
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DOI：
10.1097/qai.0000000000002377
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发表时间：
2020-08-15
影响因子：
3.6
通讯作者：
Ridgway, Jessica P.
中科院分区：
文献类型：
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作者：
Hirschhorn, Lisa R.;Brown, Rayna N.;Ridgway, Jessica P.
背景：尽管芝加哥的黑人顺性女性继续不成比例地占新的艾滋病毒诊断病例的比例，但很少有人接受暴露前预防(PrEP)。我们使用同时混合的方法来了解芝加哥女性的PrEP知识、态度、经历和偏好。地点和方法：我们调查了到性传播感染门诊(n=120)或急诊科(n=250)就诊的370名HIV(-)顺性别妇女。两个焦点小组与PrEP天真的妇女进行了交谈，并与7名有PrEP经验的妇女进行了访谈。定量数据采用描述性统计和多变量Logistic回归分析，定性数据采用主题分析。结果：大多数女性认定为黑人(83.0%)，并有固定的医疗保健来源(70.0%)。在过去的6个月中，84.1%的人有过阴道或肛交，最多的是避孕套使用不一致(94.2%)。只有30.3%的人听说过PrEP，但一旦解释清楚，四分之一的人认为开始PrEP是最常见的原因，保护健康(76.4%)和减少对HIV的担忧(58.1%)。考虑PrEP的相关因素包括拉丁裔[调整后的优势比(AOR)：3.30，95%可信区间(CI)：(1.21~8.99)]，最近的性传播感染[AOR：2.39，95%CI：(1.25~4.59)]，以及对PrEP有效性的较高信念[AOR：1.85，95%CI：(1.22~2.82)]。大多数人(81.1%)对服用PrEP的副作用表示担忧。定性主题与调查结果一致，揭示了与当前PrEP营销的脱节、社区层面PrEP教育/推广的必要性以及提供商信任的重要性。经验教训：尽管芝加哥开展了大量的PrEP实施工作，但在我们的研究中，只有不到三分之一的女性听说过PrEP。一旦被告知，PrEP的态度和兴趣是积极的。将这些结果转化为反映妇女偏好和障碍的干预措施，对于增加芝加哥和其他地方顺性妇女对PrEP的接受至关重要。
Background: Although black cisgender women in Chicago continue to disproportionally account for new HIV diagnoses, few are on pre-exposure prophylaxis (PrEP). We used concurrent mixed-methods to understand women's PrEP knowledge, attitudes, experience, and preferences in Chicago. Setting and Methods: We surveyed 370 HIV(-) cisgender women visiting a sexually transmitted infection clinic (n = 120) or emergency department (n = 250). Two focus groups were conducted with PrEP-naive women, and interviews were conducted with 7 PrEP-experienced women. Quantitative data were analyzed using descriptive statistics and multivariable logistic regression, and qualitative data using thematic analysis. Results: Majority of women identified as black (83.0%) and had a regular source of health care (70.0%). In the past 6 months, 84.1% had vaginal or anal sex, most with inconsistent condom use (94.2%). Only 30.3% had heard of PrEP, but once explained, one-quarter considered starting PrEP, with protecting health (76.4%) and reducing HIV worry (58.1%) the most common reasons. Factors associated with considering PrEP included being Latina [adjusted odds ratio (aOR): 3.30, 95% confidence interval (CI): (1.21 to 8.99)], recent sexually transmitted infection [aOR: 2.39, 95% CI: (1.25 to 4.59)], and higher belief in PrEP effectiveness [aOR: 1.85, 95% CI: (1.22 to 2.82)]. Most (81.1%) had concerns about taking PrEP with side effects a common concern. Qualitative themes aligned with survey results, revealing a disconnection from current PrEP marketing, need for community-level PrEP education/outreach, and importance of provider trust. Lessons Learned: Despite significant PrEP implementation work in Chicago, less than one-third of women in our study had heard of PrEP. Once informed, PrEP attitudes and interest were positive. Translating these results into interventions reflecting women's preferences and barriers is critical to increase PrEP uptake by cisgender women in Chicago and elsewhere.