将治疗视为预防的信念及其与艾滋病毒感染状况和行为风险的关系。
Belief in Treatment as Prevention and Its Relationship to HIV Status and Behavioral Risk.
作者信息
Card Kiffer G, Armstrong Heather L, Lachowsky Nathan J, Cui Zishan, Sereda Paul, Carter Allison, Montaner Julio S G, Hogg Robert S, Roth Eric A, Moore David M
机构信息
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada.
出版信息
J Acquir Immune Defic Syndr. 2018 Jan 1;77(1):8-16. doi: 10.1097/QAI.0000000000001557.
BACKGROUND
We evaluated attitudes toward treatment as prevention (TasP) among gay, bisexual, and other men who have sex with men (GBM) in Vancouver, Canada.
METHODS
Sexually active GBM, aged ≥16 years, were recruited between 2012 and 2015 using respondent-driven sampling. At each 6-month follow-up, participants completed a computer-administered questionnaire and nursing visit. Repeated-measures latent class analysis, grouped by self-reported serostatus, identified patterns of TasP endorsement by considering TasP-related awareness, attitudes, and behavior. Binary logistic regression identified covariates of class membership. Bivariate interactions with visit number identified factors associated with longitudinal changes in class membership.
RESULTS
A total of 774 men provided 2590 observations. Of these, 698 enrolled in the cohort, 575 had at least 1 follow-up visit. Among these, the median follow-up time was 1.98 years (Q1-Q2: 1.49-2.49 years). Repeated-measures latent class analysis identified 3 classes: "unaware" (64.2% HIV negative/unknown vs. 29.2% of HIV positive), "skeptical" (29.7% vs. 23.1%), and "believing" (6.1% vs. 47.7%). Membership in classes representing higher TasP endorsement was associated with greater odds of condomless anal sex and having more sexual partners. Age, sexual orientation, ethnicity, substance use, and social time spent with other GBM were also associated with class membership. Longitudinally, class membership was stable among HIV-positive men but shifted toward greater TasP endorsement among HIV-negative/unknown men. For HIV-negative/unknown men, increasing endorsement was positively associated with greater education, being employed, being in a relationship, and substance use and inversely associated with recent serodiscordant condomless anal sex or sexually transmitted infection diagnosis.
CONCLUSIONS
Over time, disparities in TasP diffusion by HIV status have lessened, although continue to persist across other key social strata.
背景
我们评估了加拿大温哥华男同性恋者、双性恋者及其他与男性发生性关系的男性（GBM）对治疗即预防（TasP）的态度。
方法
2012年至2015年期间，采用应答者驱动抽样法招募年龄≥16岁且性活跃的GBM。在每次6个月的随访中，参与者完成一份计算机辅助问卷和护理访视。重复测量潜在类别分析按自我报告的血清学状态分组，通过考虑与TasP相关的意识、态度和行为来确定TasP认可模式。二元逻辑回归确定类别归属的协变量。与访视次数的双变量交互作用确定了与类别归属纵向变化相关的因素。
结果
共有774名男性提供了2590次观察数据。其中，698人纳入队列，575人至少有1次随访。在这些人中，中位随访时间为1.98年（第一四分位数 - 第三四分位数：1.49 - 2.49年）。重复测量潜在类别分析确定了3个类别：“ unaware”（HIV阴性/未知者占64.2%，而HIV阳性者占29.2%）、“ skeptical”（分别占29.7%和23.1%）和“ believing”（分别占6.1%和47.7%）。代表更高TasP认可的类别成员与无保护肛交的几率更高以及性伴侣更多有关。年龄、性取向、种族、物质使用以及与其他GBM共度的社交时间也与类别归属有关。纵向来看，HIV阳性男性的类别归属稳定，但HIV阴性/未知男性的类别归属向更高的TasP认可转变。对于HIV阴性/未知男性，认可度增加与受教育程度更高、就业、处于恋爱关系以及物质使用呈正相关，与近期血清学不一致的无保护肛交或性传播感染诊断呈负相关。
结论
随着时间推移，TasP在不同HIV状态人群中的传播差异有所减小，尽管在其他关键社会阶层中仍然存在。
Zotero 插件