J. David Gladstone Institutes, 1650 Owens Street, San Francisco, CA, 94158, USA.
University of California, San Francisco, CA, USA.
AIDS Behav. 2018 Nov;22(11):3673-3680. doi: 10.1007/s10461-018-2151-0.
Qualitative studies suggest that social relationships play an important role in HIV pre-exposure prophylaxis (PrEP) use, but there have been few quantitative assessments of the role of social relationships in PrEP uptake or adherence. We examined the association between disclosure of study participation or LGBT identity and PrEP use in the 1603 HIV-negative participants enrolled in the iPrEx OLE study. We also evaluated the association between LGBT social group involvement and PrEP use. Study participation disclosure to parents and LGBT identity disclosure to anyone in a participant's social network were associated with greater PrEP uptake. Study participation disclosure to partners was associated with higher probability of having protective PrEP drug concentrations compared [risk difference 0.15 95% CI (0.01, 0.30)]. For each additional type of LGBT organization a participant was involved in, the probability of PrEP uptake and having protective drug concentrations increased by 0.04 [95% CI (0.03, 0.06)] and 0.04 (95% CI (0.02, 0.07)] respectively. Overall, social context was associated with PrEP use in iPrEx OLE, and should be taken into consideration when designing future PrEP implementation programs.
定性研究表明，社会关系在 HIV 暴露前预防（PrEP）的使用中起着重要作用，但很少有定量评估社会关系在 PrEP 使用率或坚持率方面的作用。我们研究了在 iPrEx OLE 研究中招募的 1603 名 HIV 阴性参与者中，研究参与的披露或 LGBT 身份与 PrEP 使用之间的关联。我们还评估了 LGBT 社会团体参与与 PrEP 使用之间的关联。向父母披露研究参与情况和向参与者社交网络中的任何人披露 LGBT 身份与更高的 PrEP 使用率相关。与伴侣披露研究参与情况与具有保护作用的 PrEP 药物浓度的可能性更高相关[风险差异 0.15 95%CI（0.01，0.30)]。参与者参与的每增加一个 LGBT 组织，PrEP 使用率和具有保护作用的药物浓度的可能性分别增加 0.04[95%CI（0.03，0.06)]和 0.04（95%CI（0.02，0.07)]。总体而言，社会背景与 iPrEx OLE 中的 PrEP 使用相关，在设计未来的 PrEP 实施计划时应考虑到这一点。
