纽约州艾滋病高危人群中暴露前预防和暴露后预防知晓情况的差异:纽约市和纽约州长岛,2011 - 2013年
Differences in Awareness of Pre-exposure Prophylaxis and Post-exposure Prophylaxis Among Groups At-Risk for HIV in New York State: New York City and Long Island, NY, 2011-2013.
作者信息
Walters Suzan M, Rivera Alexis V, Starbuck Lila, Reilly Kathleen H, Boldon Nyasha, Anderson Bridget J, Braunstein Sarah
机构信息
*Department of Sociology, State University of New York at Stony Brook, Stony Brook, NY; †New York City Department of Health and Mental Hygiene, New York City, NY; ‡Institute for Veterans and Military Families, Syracuse University; and §New York State Department of Health, Albany, NY.
出版信息
J Acquir Immune Defic Syndr. 2017 Jul 1;75 Suppl 3:S383-S391. doi: 10.1097/QAI.0000000000001415.
BACKGROUND
Pre-exposure prophylaxis (PrEP) to reduce the risk of HIV was approved in 2012 and post-exposure prophylaxis (PEP) in 2005. We report the differences in awareness of PrEP/PEP and factors associated with awareness by examining 3 risk groups (men who have sex with men (MSM), people who inject drugs, and high-risk heterosexuals).
METHODS
National HIV Behavioral Surveillance system data collected in New York City (NYC) and Long Island, NY in 2011-2013 were used. Logistic regressions by region were developed to estimate adjusted associations [Adjusted Odds Ratios (AOR)] and determine differences in awareness of PrEP/PEP.
RESULTS
Awareness of PrEP/PEP was low for all groups. In multivariate analysis controlling for sociodemographic factors, noninjection drug use, HIV status, and exposure to HIV prevention, males who inject drugs in NYC had significantly decreased odds of PrEP/PEP awareness [AOR: 0.45; confidence interval (CI): 0.25 to 0.81] compared with MSM. MSM aged 18-29 years had increased awareness of PrEP (AOR: 2.94; 95% CI 1.11 to 7.80). On Long Island, females who inject drugs (AOR: 0.18; 95% CI: 0.05 to 0.62), males who inject drugs (AOR: 0.14; 95% CI: 0.05 to 0.39), female heterosexuals (AOR: 0.25; 95% CI: 0.11 to 0.59), and male heterosexuals (AOR: 0.32; 95% CI: 0.14 to 0.73) had significantly decreased odds of PrEP/PEP awareness. Black MSM had increased awareness of PrEP (AOR: 4.08 CI:1.21 to 13.73).
CONCLUSIONS
Large proportions of groups at-risk for HIV were unaware of PrEP/PEP. When comparing risk groups to MSM, we found MSM to have greater awareness in both regions. On Long Island, people who inject drugs and heterosexuals were far less likely to have PrEP/PEP awareness than in NYC. On Long Island, Black MSM had increased PrEP awareness and in NYC MSM aged 18-29 had increased PrEP awareness. These findings suggest that awareness may be spreading through networks and highlight the importance of targeted educational and prevention efforts by group and region.
背景
暴露前预防(PrEP)于2012年被批准用于降低感染艾滋病毒的风险,暴露后预防(PEP)于2005年被批准。我们通过研究三个风险群体(男男性行为者(MSM)、注射吸毒者和高危异性恋者)来报告PrEP/PEP知晓率的差异以及与知晓率相关的因素。
方法
使用2011 - 2013年在纽约市(NYC)和纽约州长岛收集的全国艾滋病毒行为监测系统数据。按地区进行逻辑回归分析,以估计调整后的关联[调整优势比(AOR)]并确定PrEP/PEP知晓率的差异。
结果
所有群体对PrEP/PEP的知晓率都很低。在控制了社会人口学因素、非注射吸毒情况、艾滋病毒感染状况以及接触艾滋病毒预防措施的多变量分析中,与男男性行为者相比,纽约市注射吸毒的男性对PrEP/PEP的知晓率显著降低[AOR:0.45;置信区间(CI):0.25至0.81]。18 - 29岁的男男性行为者对PrEP的知晓率有所提高(AOR:2.94;95%CI 1.11至7.80)。在长岛,注射吸毒的女性(AOR:0.18;95%CI:0.05至0.62)、注射吸毒的男性(AOR:0.14;95%CI:0.05至0.39)、异性恋女性(AOR:0.25;95%CI:0.11至0.59)和异性恋男性(AOR:0.32;95%CI:0.14至0.73)对PrEP/PEP的知晓率显著降低。黑人男男性行为者对PrEP的知晓率有所提高(AOR:4.08 CI:1.21至13.73)。
结论
很大比例的艾滋病毒风险群体对PrEP/PEP并不知晓。在将风险群体与男男性行为者进行比较时,我们发现两个地区的男男性行为者知晓率更高。在长岛,注射吸毒者和异性恋者对PrEP/PEP的知晓率远低于纽约市。在长岛,黑人男男性行为者对PrEP的知晓率有所提高,在纽约市18 - 29岁的男男性行为者对PrEP的知晓率有所提高。这些发现表明知晓率可能正在通过人际网络传播,并突出了按群体和地区开展有针对性的教育和预防工作的重要性。