Hubach Randolph D, Currin Joseph M, Sanders Carissa A, Durham André R, Kavanaugh Katherine E, Wheeler Denna L, Croff Julie M
School of Community Health Sciences, Counseling, and Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma.
School of Educational Foundations, Leadership, and Aviation, Oklahoma State University.
AIDS Educ Prev. 2017 Aug;29(4):315-329. doi: 10.1521/aeap.2017.29.4.315.
Biomedical intervention approaches, including antiretroviral pre-exposure prophylaxis (PrEP), have been demonstrated to reduce HIV incidence among several at-risk populations and to be cost effective. However, there is limited understanding of PrEP access and uptake among men who have sex with men (MSM) residing in relatively rural states. Twenty semistructured interviews were conducted (August-November 2016) to assess opinions of and perceived barriers to accessing and adopting PrEP among MSM residing in Oklahoma. Participants perceived substantial barriers to accessing PrEP including a stigmatizing environment and less access to quality, LGBT-sensitive medical care. Overall, geographic isolation limits access to health providers and resources that support sexual health for Oklahoma MSM. Addressing stigma situated across ecological levels in an effort to increase adoption of PrEP by MSM residing in rural states remains necessary. Without this, social determinants may continue to negatively influence PrEP adoption and sexual health outcomes.
生物医学干预方法，包括抗逆转录病毒暴露前预防（PrEP），已被证明可降低多个高危人群中的艾滋病毒发病率，且具有成本效益。然而，对于居住在相对农村地区的男男性行为者（MSM）而言，对PrEP的获取和接受情况了解有限。2016年8月至11月进行了20次半结构化访谈，以评估居住在俄克拉荷马州的男男性行为者对获取和采用PrEP的看法及感知到的障碍。参与者认为获取PrEP存在重大障碍，包括充满污名的环境以及获得优质、对LGBT群体友好的医疗服务的机会较少。总体而言，地理隔离限制了俄克拉荷马州男男性行为者获得支持性健康的医疗服务提供者和资源的机会。努力消除跨生态层面的污名，以增加居住在农村地区的男男性行为者对PrEP的采用仍然很有必要。否则，社会决定因素可能会继续对PrEP的采用和性健康结果产生负面影响。
