在一项针对高度活跃的男同性恋和双性恋男性的纵向研究中，对暴露前预防措施的熟悉程度和接受意愿的变化。
Changes in Familiarity with and Willingness to Take Preexposure Prophylaxis in a Longitudinal Study of Highly Sexually Active Gay and Bisexual Men.
机构信息
1 The Center for HIV/AIDS Educational Studies & Training (CHEST) , New York, New York.
2 CUNY Graduate School of Public Health and Health Policy , New York, New York.
出版信息
LGBT Health. 2016 Aug;3(4):252-7. doi: 10.1089/lgbt.2015.0123. Epub 2016 May 16.
PURPOSE
For gay and bisexual men (GBM), research suggests that familiarity with preexposure prophylaxis (PrEP) has been increasing since being approved by the United States Food and Drug Administration in 2012. However, it is less clear how willingness to start using PrEP has changed over time. Likewise, some have expressed concerns regarding the potential for risk compensation (i.e., reduced condom use) were one to start PrEP; however, again, it is unclear how risk compensation may have changed over time.
METHODS
We conducted baseline and 12-month assessments with 158 highly sexually active HIV-negative GBM in New York City who were assessed between 2011 and 2014. We examined change over time both between participants (based on when they entered the study), as well as within each participant (over the 12 months of his involvement).
RESULTS
Familiarity with PrEP increased over time (both between and within participants); however, willingness to take PrEP did not change (neither between nor within participants). Few men believed taking PrEP would cause their condomless anal sex (CAS) to increase and this did not change over time. However, a majority believed PrEP would increase temptation for CAS, and this did not change over time within participants. Sexual compulsivity symptomology was associated with higher willingness to take PrEP and perceiving that PrEP would increase one's temptations for CAS. Furthermore, recent CAS was associated with greater willingness to take PrEP, a perception that PrEP would increase one's likelihood to engage in CAS, and a perception that being on PrEP would increase one's temptation for CAS.
CONCLUSIONS
Participants became more familiar with PrEP over time; however, willingness to start PrEP did not change, and this may serve as an opportunity for providers to discuss PrEP with their patients. Men who engaged in CAS were interested in PrEP and preexisting patterns of sexual behavior may be the primary determinant of CAS while on PrEP.
目的
对于男同性恋和双性恋者（GBM），研究表明，自 2012 年美国食品和药物管理局批准以来，他们对暴露前预防（PrEP）的熟悉程度一直在提高。然而，关于随着时间的推移，人们开始使用 PrEP 的意愿是否发生了变化，情况就不太清楚了。同样，有人担心如果开始使用 PrEP，可能会出现风险补偿（即减少使用避孕套）；然而，同样，目前尚不清楚风险补偿随时间的推移可能发生了怎样的变化。
方法
我们对 2011 年至 2014 年间在纽约市参与研究的 158 名性活跃的 HIV 阴性 GBM 进行了基线和 12 个月的评估。我们检查了随着时间的推移，参与者之间（根据他们进入研究的时间）以及每个参与者内部（在他参与的 12 个月内）的变化。
结果
对 PrEP 的熟悉程度随着时间的推移而增加（无论是在参与者之间还是在每个参与者内部）；然而，开始使用 PrEP 的意愿并没有改变（无论是在参与者之间还是在每个参与者内部）。很少有男性认为服用 PrEP 会导致他们无保护的肛交（CAS）增加，而且这种情况随着时间的推移并没有改变。然而，大多数男性认为 PrEP 会增加他们进行 CAS 的诱惑，而且这种情况在参与者内部随着时间的推移并没有改变。性强迫症状与更高的服用 PrEP 的意愿和认为 PrEP 会增加一个人进行 CAS 的诱惑有关。此外，最近发生的 CAS 与更高的服用 PrEP 的意愿、认为 PrEP 会增加一个人进行 CAS 的可能性以及认为服用 PrEP 会增加一个人进行 CAS 的诱惑有关。
结论
参与者随着时间的推移对 PrEP 越来越熟悉；然而，开始使用 PrEP 的意愿没有改变，这可能为提供者提供了一个与患者讨论 PrEP 的机会。进行过 CAS 的男性对 PrEP 感兴趣，而现有的性行为模式可能是 CAS 发生的主要决定因素。
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