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男同性恋者和双性恋男性如何弥补错过的暴露前预防(PrEP)剂量,错过一剂对他们随后的性行为有何影响?

How Do Gay and Bisexual Men Make Up for Missed PrEP Doses, and What Impact Does Missing a Dose Have on Their Subsequent Sexual Behavior?

作者信息

Grov Christian, D'Angelo Alexa B, Flynn Anthony W P, Lopez-Rios Javier, Pantalone David W, Holloway Ian W, Whitfield Thomas H F, Parsons Jeffrey T

机构信息

City University of New York (CUNY) Graduate School of Public Health and Health Policy, and the CUNY Institute for Implementation Science in Population Health, New York City.

VA Desert Pacific Mental Illness Research, Education and Clinical Center, Los Angeles, California.

出版信息

AIDS Educ Prev. 2018 Aug;30(4):275-286. doi: 10.1521/aeap.2018.30.4.275.

Abstract

HIV pre-exposure prophylaxis (PrEP) is being adopted by members of key populations, such as gay and bisexual men (GBM). Since adherence to a daily PrEP regimen ensures a maximum protection, it is critical to understand GBM's behavioral responses to having missed PrEP doses. We report on qualitative interviews with GBM taking PrEP. We identified three behavioral responses: (1) 59% continued with their next scheduled dose; (2) 49% described "making up" for a missed dose by taking medication as soon as possible; and (3) 11% reported "doubling" the next PrEP dose. Participants provided potentially contradictory narratives about their sexual behavior after a missed dose: (1) 54% described making no changes; (2) 49% described adjusting their sexual behavior to reduce HIV risk; and (3) 10% said their decision would be contingent upon how many doses were missed. For PrEP prescribers, our data provide a useful lens to understand patients' lived experiences with PrEP.

摘要

艾滋病毒暴露前预防(PrEP)正被男同性恋者和双性恋男性(GBM)等重点人群所采用。由于坚持每日PrEP方案可确保最大程度的保护,因此了解GBM对错过PrEP剂量的行为反应至关重要。我们报告了对服用PrEP的GBM进行的定性访谈情况。我们确定了三种行为反应:(1)59%的人继续服用下一次预定剂量;(2)49%的人描述通过尽快服药来“补上”错过的剂量;(3)11%的人报告在下一次PrEP剂量时“加倍”服用。参与者对于错过剂量后的性行为给出了可能相互矛盾的说法:(1)54%的人表示没有变化;(2)49%的人描述调整性行为以降低感染艾滋病毒的风险;(3)10%的人表示他们的决定将取决于错过的剂量数量。对于PrEP开处方者来说,我们的数据为理解患者服用PrEP的实际经历提供了有用的视角。

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