Gaps and Determinants in PrEP Uptake and Need: Understanding Disparities in PrEP Among Women in the United States

PrEP 采用和需求方面的差距和决定因素：了解美国女性 PrEP 方面的差异

• 批准号: 10762821
• 负责人: Brady W Bennett
• 金额: $ 4.77万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762821
• 关键词: AIDS prevention; Affect; African American; Behavior; Behavioral; Black race; Categories; Characteristics; Data; Data Set; Databases; Diagnosis; Disparate; Disparity; Eligibility Determination; Epidemic; Epidemiology; Equation; Equity; Ethnic Origin; Evaluable Disease; Family; Geography; Goals; Government; Growth; Guidelines; HIV; HIV Infections; HIV diagnosis; HIV risk; Health Personnel; Heterosexuals; Hispanic; Inequity; Infection; Knowledge; Latinx population; Logistic Regressions; Methodology; Methods; Modeling; Oral; Pattern; Performance; Pharmacologic Substance; Pharmacy facility; Policies; Public Health; Race; Records; Research; Risk; Risk Factors; Sexual Partners; Socioeconomic Status; Spatial Distribution; Surveys; Training; United States; United States Dept. of Health and Human Services; Woman; Work; black women; career; comparative; data quality; health equity; low socioeconomic status; male; men; men who have sex with men; pre-exposure prophylaxis; sex; sociodemographic factors; spatiotemporal; statistics; uptake; validation studies

ABSTRACT Women accounted for 18% of new HIV diagnoses in the United States in 2020 and yet only 7.4% of the pre- exposure prophylaxis (PrEP) users. Additionally, 71% of the women diagnosed with HIV in 2020 were Black/African American or Hispanic. PrEP has been shown to reduce incident HIV infection, providing a substantial public health opportunity to work towards the US Department of Health and Human Services announced the Ending the HIV Epidemic initiative. However, a substantial component of risk of HIV infection for women relates to the behaviors of their male sex partners, and these risks of partners may be unknown to women. Additionally, the completeness of data on race/ethnicity in key datasets used to document PrEP users in the US is limited leading to bias in our estimates. The proposed analysis will (1) determine the characteristics of women based on their partnerships that are indications for PrEP, particularly those indications unrecognized by women and their healthcare providers, 2) use multiple imputation to complete race/ethnicity data in current pharmaceutical use datasets to better understand the current racial/ethnic distribution of women PrEP users, and 3) analyze spatio-temporal patterns of PrEP uptake among women in the United States. Taken together, the goal of this proposal is to advance our understanding of among whom PrEP is needed, racial/ethnicity distributions among whom PrEP is currently being utilized, and where uptake is disparate considering risk factors for HIV infection.

抽象的 2020 年，美国新增艾滋病毒确诊病例中，女性占 18%，但仅占感染前女性的 7.4%。 暴露预防 (PrEP) 用户。此外，2020 年被诊断感染艾滋病毒的女性中有 71% 黑人/非裔美国人或西班牙裔。 PrEP 已被证明可以减少 HIV 感染事件，提供 为美国卫生与公众服务部工作的大量公共卫生机会 宣布了“终结艾滋病毒流行”倡议。然而，艾滋病毒感染风险的一个重要组成部分 女性与其男性性伴侣的行为有关，而男性性伴侣的这些风险可能不为女性所知。 女性。此外，用于记录 PrEP 用户的关键数据集中种族/民族数据的完整性 美国的情况有限，导致我们的估计存在偏差。建议的分析将 (1) 确定特征 女性基于其伙伴关系的 PrEP 指征，特别是那些未被识别的指征 由妇女及其医疗保健提供者，2）使用多重插补来完成当前的种族/民族数据 药物使用数据集，以更好地了解女性 PrEP 用户当前的种族/民族分布， 3) 分析美国女性 PrEP 摄取的时空模式。综合起来， 该提案的目标是增进我们对哪些人需要 PrEP、种族/民族的了解 目前正在使用 PrEP 的人群的分布情况，以及考虑到风险因素，其使用情况存在差异 用于艾滋病毒感染。