1 Department of Health and Mental Health Services, Los Angeles LGBT Center , Los Angeles, California.
2 Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California.
LGBT Health. 2018 Aug/Sep;5(6):341-349. doi: 10.1089/lgbt.2017.0244. Epub 2018 Aug 17.
Pre-exposure prophylaxis (PrEP) is an effective strategy to prevent HIV. However, low uptake of daily oral PrEP since Food and Drug Administration approval and low medication adherence among users have stimulated the investigation of other modalities for delivery, such as injectable PrEP and on-demand PrEP. The objective of this study was to determine the demographic and behavioral predictors of willingness to try alternative PrEP delivery mechanisms among young men who have sex with men (YMSM) who stated that they were unwilling to try daily oral PrEP.
YMSM in California were recruited through geosocial networking applications; we analyzed a subsample who stated that they were either ambivalent about trying or unwilling to try daily oral PrEP (n = 265). We used chi-square and Fisher's exact tests to determine characteristics associated with willingness to try injectable PrEP, willingness to try on-demand PrEP, and willingness to try either alternative form.
For individuals who stated that they would not be willing to try daily oral PrEP, ∼85% were willing to try on-demand and/or injectable PrEP. Individuals who reported some college or more reported greater willingness to try injectable PrEP (adjusted odds ratio [aOR]: 2.92; 95% confidence interval [CI]: 1.32-6.46), on-demand PrEP (aOR: 2.28; 95% CI: 1.06-4.90), or either method (aOR: 5.54; 95% CI: 1.78-17.22).
Future research should determine how to enhance uptake of emerging forms of PrEP among the individuals most at risk for HIV.
暴露前预防(PrEP)是预防 HIV 的有效策略。然而,自食品和药物管理局批准以来,每日口服 PrEP 的使用率较低,且使用者的药物依从性较低,这促使人们研究其他传递方式,如注射用 PrEP 和按需 PrEP。本研究的目的是确定那些表示不愿意尝试每日口服 PrEP 的男男性行为者(MSM)中,不愿意尝试每日口服 PrEP 的个体尝试替代 PrEP 传递方式的意愿的人口统计学和行为预测因素。
通过社交网络应用程序招募加利福尼亚州的 MSM;我们分析了一组表示他们对尝试每日口服 PrEP 犹豫不决或不愿意尝试的亚组(n=265)。我们使用卡方和 Fisher 精确检验来确定与愿意尝试注射用 PrEP、愿意尝试按需 PrEP 以及愿意尝试任何一种替代形式相关的特征。
对于那些表示不愿意尝试每日口服 PrEP 的个体,约 85%的人愿意尝试按需和/或注射用 PrEP。报告接受过一些大学或更高教育的个体报告了更高的尝试注射用 PrEP 的意愿(调整后的优势比[aOR]:2.92;95%置信区间[CI]:1.32-6.46)、按需 PrEP(aOR:2.28;95% CI:1.06-4.90)或任何一种方法(aOR:5.54;95% CI:1.78-17.22)。
未来的研究应该确定如何提高最易感染 HIV 的个体对新兴 PrEP 形式的接受度。