Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Prev Sci. 2019 Oct;20(7):1089-1097. doi: 10.1007/s11121-019-00995-6.
Despite demonstrated efficacy, uptake of HIV pre-exposure prophylaxis (PrEP) remains low, particularly among high-risk demographics such as transgender women, Black men who have sex with men (BMSM), and young MSM (YMSM). Research thus far has largely focused on individual factors that may impede PrEP uptake in these demographics, leaving social network factors relatively unexplored. The present study used data collected from participants within RADAR, a longitudinal cohort study in Chicago focused on understanding the individual, dyadic, network, social, and biologic factors associated with HIV infection within YMSM. Of the 906 study participants who did not report an HIV diagnosis at baseline, 7.0% reported using PrEP in the prior 6 months. Recent PrEP use was associated with both individual-level (age and gender) and network-level factors (mean relationship strength, sexual network degree, etc.). These findings highlight the need to expand beyond focusing on individual-level drivers of PrEP uptake, as well as changing our understanding of who is most important within a network (centrality vs. strength of weak ties). Future work is needed to determine whether variables associated with PrEP uptake are similarly connected to PrEP adherence.
尽管已证实有效，但艾滋病毒暴露前预防（PrEP）的采用率仍然很低，特别是在跨性别女性、与男性发生性关系的黑人男性（BMSM）和年轻男男性行为者（YMSM）等高危人群中。迄今为止，研究主要集中在可能阻碍这些人群中 PrEP 采用的个体因素上，而社交网络因素相对未得到充分探索。本研究使用了从 RADAR 参与者那里收集的数据，RADAR 是一项在芝加哥进行的纵向队列研究，旨在了解与 YMSM 内艾滋病毒感染相关的个体、对偶、网络、社会和生物学因素。在基线时未报告 HIV 诊断的 906 名研究参与者中，有 7.0%报告在过去 6 个月内使用过 PrEP。最近使用 PrEP 与个体层面（年龄和性别）和网络层面因素（平均关系强度、性网络程度等）有关。这些发现强调需要超越关注 PrEP 采用的个体层面驱动因素，并改变我们对网络中谁最重要的理解（中心度与弱关系的强度）。需要进一步研究以确定与 PrEP 采用相关的变量是否与 PrEP 坚持使用同样相关。
