Puppo Costanza, Mabire Xavier, Cotte Laurent, Castro Daniela Rojas, Spire Bruno, Cua Eric, Pialoux Gilles, Monti Marie Suzan, Pasquet Armelle, Raffi François, Molina Jean-Michel, Préau Marie
GRePS, Lyon 2 University, Lyon, France.
Hôpital Croix Rousse, Lyon, France.
AIDS Educ Prev. 2019 Jun;31(3):259-272. doi: 10.1521/aeap.2019.31.3.259.
ANRS-IPERGAY was a community-based randomized trial investigating the efficacy of sexual activity-based HIV pre-exposure prophylaxis (PrEP) in a population of males and transgender females who had sex with men and were at high risk of HIV infection. We qualitatively analyzed the support provided to participants by community-based health workers (CBHW) throughout the trial's double-blind and open-label extension phases. In particular, we showed that the relationship between participants and CBHW strongly influenced self-managed pill intake. The delicate construction of this relationship, balanced between trust and dependence, played an important role in PrEP adherence. CBHW had to deal with various issues surrounding participants' feelings of empowerment regarding their role in the trial, as well as related tensions between various logics and rationalities. They were essential to participants' continued involvement.
ANRS-IPERGAY是一项基于社区的随机试验，旨在调查基于性活动的HIV暴露前预防（PrEP）在与男性发生性行为且感染HIV风险较高的男性和跨性别女性群体中的疗效。我们对社区卫生工作者（CBHW）在整个试验的双盲和开放标签扩展阶段为参与者提供的支持进行了定性分析。特别是，我们发现参与者与CBHW之间的关系对自我管理的药丸服用有很大影响。这种关系的微妙构建，在信任和依赖之间取得平衡，对PrEP的依从性起到了重要作用。CBHW必须处理围绕参与者对其在试验中的角色的赋权感的各种问题，以及各种逻辑和合理性之间的相关紧张关系。他们对参与者的持续参与至关重要。
