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肯尼亚男同性恋、双性恋及其他与男性发生性行为的男性(GBMSM)对暴露前预防(PrEP)的知晓率和接受度。

Awareness and Acceptability of pre-exposure prophylaxis (PrEP) among gay, bisexual and other men who have sex with men (GBMSM) in Kenya.

作者信息

Ogunbajo Adedotun, Kang Augustine, Shangani Sylvia, Wade Ryan M, Onyango Daniel P, Odero Wilson W, Harper Gary W

机构信息

a Department of Behavioral and Social Sciences, Brown University School of Public Health , Providence , RI , USA.

b Center for Health Equity, Brown University School of Public Health , Providence , RI , USA.

出版信息

AIDS Care. 2019 Oct;31(10):1185-1192. doi: 10.1080/09540121.2019.1612023. Epub 2019 Apr 30.

Abstract

Kenyan gay, bisexual, and other men who have sex with men (GBMSM) are significantly affected by HIV. Pre-exposure prophylaxis (PrEP) is an effective biomedical approach to HIV prevention. We conducted a cross-sectional survey of 459 HIV-negative Kenyan GBMSM to assess individual and interpersonal correlates of PrEP awareness/acceptability using univariate and hierarchical logistic regression modeling. We found that 64.3% of participants had heard of PrEP and 44.9% were willing to use PrEP. In hierarchical logistic regression models for PrEP awareness, condom use with regular partners, higher condom use self-efficacy, higher perceived ability to use PrEP, history of STI, and membership in LGBT organization were significantly associated with being aware of PrEP (=69.6,  < .001). In hierarchical logistic regression models for PrEP acceptability, higher self-esteem, higher condom use self-efficacy, depression/anxiety, higher perceived ability to use PrEP, willingness to engage in PrEP follow-up visits, coercion at sexual debut, and family exclusion were significantly associated with being acceptable to PrEP (=231.8,  < .001). Individual and interpersonal factors were significantly associated with PrEP awareness and acceptability. Our findings underscore the need to promote awareness and understanding of PrEP as an effective HIV prevention tool in combination with other safer-sex methods that are appropriate given an individual's personal circumstances.

摘要

肯尼亚的男同性恋者、双性恋者以及其他与男性发生性行为的男性(GBMSM)受艾滋病毒的影响尤为严重。暴露前预防(PrEP)是一种有效的预防艾滋病毒的生物医学方法。我们对459名未感染艾滋病毒的肯尼亚GBMSM进行了一项横断面调查,采用单变量和分层逻辑回归模型评估PrEP知晓率/可接受性的个体和人际相关因素。我们发现,64.3%的参与者听说过PrEP,44.9%的人愿意使用PrEP。在PrEP知晓率的分层逻辑回归模型中,与固定性伴使用避孕套、更高的避孕套使用自我效能感、更高的PrEP使用感知能力、性传播感染病史以及LGBT组织成员身份与知晓PrEP显著相关(=69.6, < .001)。在PrEP可接受性的分层逻辑回归模型中,更高的自尊、更高的避孕套使用自我效能感、抑郁/焦虑、更高的PrEP使用感知能力、愿意接受PrEP随访、首次性行为时受到胁迫以及被家庭排斥与接受PrEP显著相关(=231.8, < .001)。个体和人际因素与PrEP知晓率和可接受性显著相关。我们的研究结果强调,有必要提高对PrEP作为一种有效艾滋病毒预防工具的认识和理解,并结合根据个人情况适当采用的其他安全性行为方法。

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