Bauermeister Jose A, Meanley Steven, Pingel Emily, Soler Jorge H, Harper Gary W
University of Michigan School of Public Health, 1415 Washington Heights, SPH I, Room 3822, Ann Arbor, MI 48109-2029, USA.
Curr HIV Res. 2013 Oct;11(7):520-7. doi: 10.2174/1570162x12666140129100411.
Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV infections among young men who have sex with men (YMSM). Using a cross-sectional survey of YMSM (N=1,507; ages 18-24), we gauged YMSM's PrEP awareness and PrEP-related beliefs regarding side effects, accessibility, and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older, more educated, were residentially unstable in the prior 30 days, had insurance, or reported having at least one sexually transmitted infection in their lifetime. We found no differences by race/ethnicity, history of incarceration, or recent sexual risk behavior. In multivariate linear regression models, Black and Latino YMSM were more likely than Whites to state they would not use PrEP because of side effect concerns. YMSM were more likely to indicate that they would not be able to afford PrEP if they did not have insurance or if they had a prior sexually transmitted infection, PrEP rollout may be hindered due to lack of awareness, as well as perceived barriers regarding its use. We propose strategies to maximize equity in PrEP awareness and access if it is to be scaled up among YMSM.
暴露前预防(PrEP)有可能帮助减少男男性行为者(YMSM)中的新增艾滋病毒感染病例。通过对YMSM(N = 1507;年龄在18至24岁之间)进行横断面调查,我们评估了YMSM对PrEP的知晓情况以及他们对PrEP副作用、可及性和可负担性的相关看法。总体而言,样本中有27%听说过PrEP;1%报告在性行为前曾使用过PrEP。在多变量逻辑回归分析中,我们发现,如果YMSM年龄较大、受教育程度较高、在过去30天内居住不稳定、有保险或者报告一生中至少感染过一种性传播感染,那么他们更有可能听说过PrEP。我们发现,在种族/族裔、监禁史或近期性风险行为方面没有差异。在多变量线性回归模型中,黑人及拉丁裔YMSM比白人更有可能表示,由于担心副作用,他们不会使用PrEP。如果没有保险或者有过性传播感染史,YMSM更有可能表示他们负担不起PrEP。由于缺乏认知以及在PrEP使用方面存在感知障碍,PrEP的推广可能会受到阻碍。我们提出了一些策略,以便在YMSM中扩大PrEP使用规模时,最大限度地实现PrEP认知和获取方面的公平性。