Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, GCR 538, Atlanta, GA, 30322, USA.
Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA.
AIDS Behav. 2019 Nov;23(11):2966-2979. doi: 10.1007/s10461-019-02591-9.
Limited studies to date assess barriers to and facilitators of PrEP uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. We examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama. Participants were 32 years old on average, 66% Black, 66% gay or lesbian, 70% male, and 66% single. Perceived barriers to PrEP access included: lack of PrEP awareness and advertisement; sexuality-related stigma; time and resource constraints; and concerns about the adequacy and technical quality of PrEP services. Perceived facilitators to PrEP access were: PrEP-related information gathering and sharing; increased dialogue and visibility around PrEP; social, programmatic, and clinical support; and, lastly, self-preservation; personal motivation; and treatment self-efficacy. Results point to opportunities to address complex barriers to equitable PrEP access using multilevel and multimodal solutions.
迄今为止，有限的研究使用以患者为中心的护理获取框架，评估了不同社会人口群体或美国南部地区（艾滋病毒负担不成比例的地区）中，接受和利用 PrEP 的障碍和促进因素。我们在阿拉巴马州伯明翰市对 44 名当前和潜在的 PrEP 用户进行了定性访谈，以研究他们对 PrEP 获取的看法。参与者的平均年龄为 32 岁，66%为黑人，66%为同性恋或双性恋，70%为男性，66%为单身。PrEP 获取的感知障碍包括：缺乏 PrEP 意识和宣传；与性相关的污名；时间和资源限制；以及对 PrEP 服务的充分性和技术质量的担忧。PrEP 获取的感知促进因素包括：PrEP 相关信息的收集和共享；增加围绕 PrEP 的对话和可见度；社会、计划和临床支持；最后，自我保护；个人动力；和治疗自我效能。研究结果表明，有机会使用多层次和多模式的解决方案来解决公平获得 PrEP 的复杂障碍。
