Loma Linda University School of Public Health, Sanitarium Dr., Loma Linda, CA, 92354, USA.
Department of Medicine and Public Health, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-2283, USA.
AIDS Behav. 2018 Nov;22(11):3603-3616. doi: 10.1007/s10461-018-2095-4.
Despite documented effectiveness of pre-exposure prophylaxis (PrEP), PrEP uptake remains low among at-risk populations. The 2015 CDC report estimates that about 1.2 million people in the US have indications for PrEP. However, only 49,158 or 4% of the targeted population are currently using PrEP. Efforts to optimize uptake of PrEP may be facilitated by the development of a comprehensive theoretical framework which can be used to understand reasons for poor uptake and to develop interventions to maximize PrEP uptake and adherence. This article reviews research on correlates of PrEP uptake and presents findings organized within an Information-Motivation-Behavioral Skills (IMB) model framework. In the context of PrEP uptake, the IMB model asserts that to the extent that at-risk groups are well-informed about PrEP, motivated to act on their knowledge, and have necessary behavioral skills to seek out and initiate PrEP regimen, they will successfully overcome obstacles to initiate and adhere to PrEP. The article proposes an adaptation the IMB model for PrEP uptake, provides empirical support for the adapted IMB model extracted from related research, and discusses its application in PrEP uptake interventions.
尽管有文献证明了暴露前预防（PrEP）的有效性，但高危人群中 PrEP 的使用率仍然很低。2015 年美国疾病控制与预防中心的报告估计，美国约有 120 万人有接受 PrEP 的指征。然而，目前只有 49158 人或目标人群的 4%正在使用 PrEP。通过开发一个全面的理论框架，可以促进 PrEP 使用率的优化，该框架可用于了解使用率低的原因，并制定干预措施，以最大限度地提高 PrEP 的使用率和依从性。本文综述了 PrEP 使用率的相关研究，并根据信息-动机-行为技能（IMB）模型框架组织研究结果。在 PrEP 使用率方面，IMB 模型认为，在一定程度上，高危人群对 PrEP 有充分的了解，有采取行动的动机，并且有必要的行为技能来寻求并开始 PrEP 疗程，他们将成功克服启动和坚持 PrEP 的障碍。本文提出了一个适用于 PrEP 使用率的 IMB 模型改编版，从相关研究中提取了对改编的 IMB 模型的实证支持，并讨论了其在 PrEP 使用率干预中的应用。
