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“消除恐惧:”理解艾滋病毒暴露前预防如何促进消除男男性行为者之间的血清学鸿沟。

"Losing the Phobia:" Understanding How HIV Pre-exposure Prophylaxis Facilitates Bridging the Serodivide Among Men Who Have Sex With Men.

作者信息

Koester Kimberly A, Erguera Xavier A, Kang Dufour Mi-Suk, Udoh Ifeoma, Burack Jeffrey H, Grant Robert M, Myers Janet J

机构信息

Division of Prevention Science, Center for AIDS Prevention Research, School of Medicine, University of California, San Francisco, San Francisco, CA, United States.

East Bay AIDS Center, Sutter Health, Oakland, CA, United States.

出版信息

Front Public Health. 2018 Sep 6;6:250. doi: 10.3389/fpubh.2018.00250. eCollection 2018.

Abstract

The use of HIV serostatus information has played a pivotal role in partner selection norms. A phenomenon known as is the practice of selecting a partner based on a perception that they are of the HIV status in order to avoid transmission from one partner to the other. An understudied aspect of serosorting is that it has a divisive effect-one accepts or rejects a potential partner based on a singular characteristic, the partner's HIV status, and thus excludes all others. This division has been formally referred to as the HIV . In this study, we explored partner selection strategies among a group of HIV-negative, young men who have sex with men ( = 29) enrolled in a PrEP demonstration project in Northern California. We found that trends in serosorting were in fact shifting, and that a new and opposite phenomenon was emerging, something we labeled "seromixing" and that PrEP use played a part in why norms were changing. We present three orientations in this regard: (1) : in which men justified the continued vigilance and exclusion of people living with HIV as viable sex or romantic partners, (2) : among men who were reflecting on their stance on serosorting and its implications for future sexual and/or romantic partnerships, and (3) a: among men letting go of serosorting practices and reducing sentiments of HIV-related stigma. The majority of participants spoke of changing or changed attitudes about intentionally accepting rather than rejecting a person living with HIV as a sex partner. For those who maintained strict serosorting practices, their understandings of HIV risk were not erased as a result of PrEP use. These overarching themes help explain how PrEP use is contributing to a closing of the HIV serodivide.

摘要

艾滋病毒血清状态信息的使用在性伴侣选择规范中发挥了关键作用。一种被称为“血清分类”的现象是,人们基于认为潜在伴侣具有相同艾滋病毒状态的认知来选择伴侣,以避免病毒在伴侣间传播。血清分类一个较少被研究的方面是它具有分裂性——人们基于一个单一特征(伴侣的艾滋病毒状态)来接受或拒绝潜在伴侣,从而排斥所有其他因素。这种分裂被正式称为“艾滋病毒血清鸿沟”。在本研究中,我们探讨了一组参与北加利福尼亚州暴露前预防示范项目的艾滋病毒阴性男男性行为者(n = 29)的性伴侣选择策略。我们发现血清分类的趋势实际上正在转变,一种新的、相反的现象正在出现,我们将其标记为“血清混合”,并且暴露前预防的使用在规范变化的原因中起到了一定作用。在这方面我们呈现了三种倾向:(1)“持续警惕”:男性将对艾滋病毒感染者作为可行的性伴侣或浪漫伴侣的持续警惕和排斥合理化;(2)“反思立场”:男性反思他们对血清分类的立场及其对未来性和/或浪漫伴侣关系的影响;(3)“摒弃分类”:男性摒弃血清分类做法并减少与艾滋病毒相关的污名感。大多数参与者谈到对有意接受而非拒绝艾滋病毒感染者作为性伴侣的态度正在改变或已经改变。对于那些维持严格血清分类做法的人来说,他们对艾滋病毒风险的认知并未因使用暴露前预防而消除。这些总体主题有助于解释暴露前预防的使用是如何促使艾滋病毒血清鸿沟缩小的。

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