为何我停止使用暴露前预防药物（PrEP）？一项混合方法研究探索男同性恋和双性恋男性停止使用 PrEP 的原因及潜在重新使用的可能性。
Why I Quit Pre-Exposure Prophylaxis (PrEP)? A Mixed-Method Study Exploring Reasons for PrEP Discontinuation and Potential Re-initiation Among Gay and Bisexual Men.
机构信息
Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA.
Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.
出版信息
AIDS Behav. 2018 Nov;22(11):3566-3575. doi: 10.1007/s10461-018-2045-1.
Abstract
Literature concerning pre-exposure prophylaxis (PrEP) among gay and bisexual identifying men (GBM) has explored facilitators and barriers to uptake and adherence. Far less reported are the reasons why GBM discontinue PrEP use. A national sample of 1071 GBM completed surveys about PrEP use and discontinuation. Participants who were still taking PrEP the 24-month follow up were compared to those that had stopped. Eighteen percent (n = 31) of GBM who reported ever using PrEP discontinued use. Younger (AOR = 0.96; 95% CI 0.92-1.00), and unemployed (AOR = 4.58; 95% CI 1.43-14.70) GBM were more likely to discontinue PrEP than their counterparts. Those that discontinued provided details on why via a free response question. The most common reasons for discontinuation were lower perceived HIV risk (50%) and cost/insurance (30%). Reasons for potential re-initiation included higher-risk sexual activities and changes to structural related barriers. More research is needed to inform interventions on how GBM can continue taking PrEP during changes to employment that effect insurance coverage and cost.
摘要
关于男同性恋和双性恋者（GBM）暴露前预防（PrEP）的文献探讨了接受和坚持 PrEP 的促进因素和障碍。报告中很少涉及 GBM 停止使用 PrEP 的原因。对全国 1071 名 GBM 进行了关于 PrEP 使用和停用的调查。在 24 个月的随访中仍在服用 PrEP 的参与者与已停止服用的参与者进行了比较。报告曾使用过 PrEP 的 GBM 中有 18%（n=31）停止了使用。年轻（AOR=0.96；95%CI 0.92-1.00）和失业（AOR=4.58；95%CI 1.43-14.70）的 GBM 比同龄人更有可能停止使用 PrEP。那些停止使用 PrEP 的人通过自由回答问题详细说明了原因。停止使用 PrEP 的最常见原因是认为 HIV 风险较低（50%）和费用/保险（30%）。潜在重新开始使用的原因包括高危性行为和与结构相关的障碍发生变化。需要进一步研究，以告知如何在影响保险覆盖范围和费用的就业变化期间，GBM 可以继续使用 PrEP 的干预措施。
相似文献
1
Why I Quit Pre-Exposure Prophylaxis (PrEP)? A Mixed-Method Study Exploring Reasons for PrEP Discontinuation and Potential Re-initiation Among Gay and Bisexual Men.为何我停止使用暴露前预防药物（PrEP）？一项混合方法研究探索男同性恋和双性恋男性停止使用 PrEP 的原因及潜在重新使用的可能性。
AIDS Behav. 2018 Nov;22(11):3566-3575. doi: 10.1007/s10461-018-2045-1.
2
Willingness to use and have sex with men taking HIV pre-exposure prophylaxis (PrEP): results of online surveys of Australian gay and bisexual men, 2011-2015.与正在服用艾滋病毒暴露前预防药物（PrEP）的男性发生性行为并使用该药物的意愿：2011 - 2015年澳大利亚男同性恋者和双性恋男性在线调查结果
Sex Transm Infect. 2017 Sep;93(6):438-444. doi: 10.1136/sextrans-2016-052774. Epub 2017 Jan 20.
3
Comfort Relying on HIV Pre-exposure Prophylaxis and Treatment as Prevention for Condomless Sex: Results of an Online Survey of Australian Gay and Bisexual Men.依靠 HIV 暴露前预防和治疗即预防措施进行无保护性行为的安心感：澳大利亚男同性恋和双性恋男性在线调查结果。
AIDS Behav. 2018 Nov;22(11):3617-3626. doi: 10.1007/s10461-018-2097-2.
4
Differences Between Groups of Pre-exposure Prophylaxis (PrEP) Using Couples in HIV-Negative/Unknown Relationships.HIV 阴性/未知关系中使用伴侣的预防暴露前预防性治疗（PrEP）的分组差异。
J Acquir Immune Defic Syndr. 2019 Aug 1;81(4):419-428. doi: 10.1097/QAI.0000000000002058.
5
Clinical exigencies, psychosocial realities: negotiating HIV pre-exposure prophylaxis beyond the cascade among gay, bisexual and other men who have sex with men in Canada.临床需求，社会心理现实：在加拿大男同性恋、双性恋和其他男男性行为者中，超越艾滋病病毒暴露前预防的传播链进行协商。
J Int AIDS Soc. 2018 Nov;21(11):e25211. doi: 10.1002/jia2.25211.
6
Familiarity with and Preferences for Oral and Long-Acting Injectable HIV Pre-exposure Prophylaxis (PrEP) in a National Sample of Gay and Bisexual Men in the U.S.美国男同性恋和双性恋男性全国样本中对口服和长效注射用艾滋病毒暴露前预防（PrEP）的熟悉程度和偏好
AIDS Behav. 2016 Jul;20(7):1390-9. doi: 10.1007/s10461-016-1370-5.
7
Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year.过去一年中曾有过性化药物使用经历的中国男同性恋、双性恋和其他男男性行为者中，PrEP 的使用率和使用意愿。
BMC Infect Dis. 2020 Apr 22;20(1):299. doi: 10.1186/s12879-020-05024-4.
8
Will Gay and Bisexual Men Taking Oral Pre-exposure Prophylaxis (PrEP) Switch to Long-Acting Injectable PrEP Should It Become Available?男同性恋和双性恋者在有口服暴露前预防（PrEP）的情况下，是否会在长效注射型 PrEP 问世后转而使用长效注射型 PrEP？
AIDS Behav. 2018 Apr;22(4):1184-1189. doi: 10.1007/s10461-017-1907-2.
9
Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013-17.澳大利亚墨尔本和悉尼男同性恋和双性恋男性群体中避孕套使用和 HIV 暴露前预防措施的采用率在社区层面上的变化：2013-2017 年重复行为监测的结果。
Lancet HIV. 2018 Aug;5(8):e448-e456. doi: 10.1016/S2352-3018(18)30072-9. Epub 2018 Jun 6.
10
Pre-exposure prophylaxis (PrEP) uptake and adherence experiences of gay and bisexual men who engage in chemsex: A qualitative study.从事化学性行为的男同性恋者和双性恋者的暴露前预防（PrEP）使用情况及依从性体验：一项定性研究
Int J Drug Policy. 2022 May;103:103630. doi: 10.1016/j.drugpo.2022.103630. Epub 2022 Feb 26.
引用本文的文献
1
Impact of changing pre-exposure prophylaxis regimens on retention among men who have sex with men in Hanoi, Vietnam (2020-2023): a cohort study.越南河内男男性行为者中暴露前预防方案变化对留存率的影响（2020 - 2023年）：一项队列研究
J Int AIDS Soc. 2025 Jul;28 Suppl 2(Suppl 2):e26478. doi: 10.1002/jia2.26478.
2
Subpopulations with frequent healthcare barriers have increased risk of sexually transmitted infections and dropping out from HIV preexposure prophylaxis care.存在频繁医疗保健障碍的亚人群感染性传播感染以及退出HIV暴露前预防护理的风险增加。
AIDS. 2025 Sep 1;39(11):1610-1620. doi: 10.1097/QAD.0000000000004224. Epub 2025 Jul 1.
3
The Effect of Behavioral Regulation on Condomless Anal Sex Among Young Sexual Minority Men: Influences of Sex-Related Substance Use, Partnership Type, and PrEP Use.行为调节对年轻性少数男性无保护肛交的影响：性相关物质使用、性伴类型和暴露前预防使用的影响
AIDS Behav. 2025 May 29. doi: 10.1007/s10461-025-04753-4.
4
Inequities in PrEP annualized pill-day coverage, United States, 2018-2022: a cross-sectional pharmacoequity analysis.2018 - 2022年美国暴露前预防（PrEP）年度化服药日覆盖率的不平等：一项横断面药物公平性分析
J Int AIDS Soc. 2025 May;28(5):e26459. doi: 10.1002/jia2.26459.
5
A Competing Risks Duration Model to Study PrEP Discontinuation Among MSM in France: The ERAS 2023 Study.一项用于研究法国男男性行为者中暴露前预防（PrEP）停药情况的竞争风险持续时间模型：ERAS 2023研究
AIDS Behav. 2025 Apr 30. doi: 10.1007/s10461-025-04729-4.
6
Low HIV-risk aligned discontinuation among HIV pre-exposure prophylaxis users within public HIV clinics in Kenya: A mixed method study.肯尼亚公共艾滋病毒诊所中艾滋病毒暴露前预防使用者中低艾滋病毒风险相关停药情况：一项混合方法研究
PLOS Glob Public Health. 2025 Apr 28;5(4):e0004493. doi: 10.1371/journal.pgph.0004493. eCollection 2025.
7
Agreements and Disagreements Between Professionals and Users About the Experience of a Telehealth Service for HIV Pre-Exposure Prophylaxis (TelePrEP): Qualitative Interview Study.专业人员与使用者之间关于艾滋病病毒暴露前预防远程医疗服务（TelePrEP）体验的共识与分歧：定性访谈研究
J Med Internet Res. 2025 Apr 2;27:e67445. doi: 10.2196/67445.
8
Randomized controlled trial of a relationship education and HIV prevention program for young male couples: Biomedical and behavioral outcomes.针对年轻男性伴侣的关系教育与艾滋病预防项目的随机对照试验：生物医学及行为学结果
Health Psychol. 2025 Mar;44(3):297-309. doi: 10.1037/hea0001448.
9
Facilitators and Barriers to Hiv Pre-Exposure Prophylaxis Adherence and Retention Among Young Men Who have Sex With Men: A Meta-Ethnographic Scoping Review.男男性行为者中艾滋病病毒暴露前预防依从性和持续性的促进因素与障碍：一项元民族志范围综述
AIDS Behav. 2025 Apr;29(4):1075-1088. doi: 10.1007/s10461-024-04582-x. Epub 2025 Feb 10.
10
Preferences for HIV preexposure prophylaxis care among gay, bisexual, and other MSM: a large discrete choice experiment.男同性恋、双性恋及其他男男性行为者对HIV暴露前预防护理的偏好：一项大型离散选择实验
AIDS. 2025 Jun 1;39(7):905-911. doi: 10.1097/QAD.0000000000004124. Epub 2025 Jan 15.
本文引用的文献
1
Home-based pre-exposure prophylaxis (PrEP) services for gay and bisexual men: An opportunity to address barriers to PrEP uptake and persistence.为男同性恋者和双性恋者提供的基于家庭的暴露前预防（PrEP）服务：解决PrEP使用和持续存在障碍的一个契机。
PLoS One. 2017 Dec 27;12(12):e0189794. doi: 10.1371/journal.pone.0189794. eCollection 2017.
2
Will Gay and Bisexual Men Taking Oral Pre-exposure Prophylaxis (PrEP) Switch to Long-Acting Injectable PrEP Should It Become Available?男同性恋和双性恋者在有口服暴露前预防（PrEP）的情况下，是否会在长效注射型 PrEP 问世后转而使用长效注射型 PrEP？
AIDS Behav. 2018 Apr;22(4):1184-1189. doi: 10.1007/s10461-017-1907-2.
3
Lessons for Patient Education Around Long-Acting Injectable PrEP: Findings from a Mixed-Method Study of Phase II Trial Participants.长效注射型 HIV 预防药物（PrEP）患者教育的启示：来自 II 期临床试验参与者混合方法研究的结果。
AIDS Behav. 2018 Apr;22(4):1209-1216. doi: 10.1007/s10461-017-1871-x.
4
Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.保险覆盖范围对艾滋病病毒暴露前预防措施使用情况的影响。
PLoS One. 2017 May 30;12(5):e0178737. doi: 10.1371/journal.pone.0178737. eCollection 2017.
5
Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a National Cohort of Gay and Bisexual Men in the United States.美国一个全国性男同性恋和双性恋男性队列中艾滋病病毒暴露前预防（PrEP）的使用情况。
J Acquir Immune Defic Syndr. 2017 Mar 1;74(3):285-292. doi: 10.1097/QAI.0000000000001251.
6
Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men.美国男男性行为者对长效暴露前预防（PrEP）、每日口服PrEP或使用避孕套预防HIV的偏好
AIDS Behav. 2017 May;21(5):1336-1349. doi: 10.1007/s10461-016-1565-9.
7
Brief Report: PrEP Uptake, Adherence, and Discontinuation Among California YMSM Using Geosocial Networking Applications.简短报告：使用地理社交网络应用程序的加利福尼亚年轻男男性行为者中的暴露前预防（PrEP）使用情况、依从性和停药情况
J Acquir Immune Defic Syndr. 2017 Jan 1;74(1):15-20. doi: 10.1097/QAI.0000000000001164.
8
Familiarity with and Preferences for Oral and Long-Acting Injectable HIV Pre-exposure Prophylaxis (PrEP) in a National Sample of Gay and Bisexual Men in the U.S.美国男同性恋和双性恋男性全国样本中对口服和长效注射用艾滋病毒暴露前预防（PrEP）的熟悉程度和偏好
AIDS Behav. 2016 Jul;20(7):1390-9. doi: 10.1007/s10461-016-1370-5.
9
Recruiting a U.S. national sample of HIV-negative gay and bisexual men to complete at-home self-administered HIV/STI testing and surveys: Challenges and Opportunities.招募美国全国范围内的HIV阴性男同性恋者和双性恋男性样本，以完成家庭自我管理的HIV/性传播感染检测和调查：挑战与机遇
Sex Res Social Policy. 2016 Mar 1;13(1):1-21. doi: 10.1007/s13178-015-0212-y.
10
Self-Perception of HIV Risk and Candidacy for Pre-Exposure Prophylaxis Among Men Who Have Sex with Men Testing for HIV at Commercial Sex Venues in New York City.在纽约市商业性场所进行 HIV 检测的男男性行为者中，自我感知 HIV 风险与接受暴露前预防的意愿。
LGBT Health. 2014 Sep;1(3):218-24. doi: 10.1089/lgbt.2013.0046. Epub 2014 Jun 17.
Zotero 插件