城市南非异性恋男性对长效注射型 HIV 暴露前预防（PrEP）需求的决定因素。
Determinants of heterosexual men's demand for long-acting injectable pre-exposure prophylaxis (PrEP) for HIV in urban South Africa.
机构信息
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
出版信息
BMC Public Health. 2019 Jul 24;19(1):996. doi: 10.1186/s12889-019-7276-1.
BACKGROUND
Heterosexual men in South Africa are a large key population to exposure to HIV, yet preferences for HIV pre-exposure prophylaxis (PrEP) among this population have not, to date, been investigated in the literature. This paper aims to explore HIV prevention preferences among heterosexual men in urban South Africa, as well as to examine the demand and characteristics of men who favour long-acting injectable (LAI) PrEP over condoms and oral PrEP.
METHODS
Data were collected among 178 self-reported HIV-negative heterosexual men, who were given example products and information before being asked which they preferred. Multivariate logistic regression was used to analyse which characteristics were associated with product choice.
RESULTS
48% (n = 85) of participants preferred LAI PrEP, while 33% (n = 58) and 20% (n = 35) chose oral PrEP and condoms respectively. Having children (marginal effect = 0.22; 95% CI [0.01, 0.44]) or having higher risk attitude scores (marginal effect = 0.03; 95% CI [0.01, 0.06]) was significantly associated with a choice of LAI PrEP, while those who had unprotected anal intercourse (marginal effect = - 0.42; 95% CI [- 0.57, - 0.27]) and those who were concerned with protection against other sexually transmitted infections over HIV (marginal effect = - 0.42; 95% CI [- 0.60, - 0.24]) appeared less likely to prefer LAI PrEP.
CONCLUSIONS
The results suggested a relatively high demand and theoretical acceptability for LAI PrEP among heterosexual men in urban South Africa, but there appeared to be fewer distinct predictors for the willingness to use LAI PrEP compared to studies conducted among gay and bisexual men and women. Nevertheless, the findings contribute to the mapping of the demand and determinants of heterosexual men's preferences for novel antiretroviral-based prevention in sub-Saharan Africa, and the data could aid in the differentiated design of future HIV prevention strategies using LAI PrEP in conjunction with other methods.
背景
南非的异性恋男性是感染 HIV 的一个重要人群，但迄今为止，文献中尚未探讨该人群对 HIV 暴露前预防 (PrEP) 的偏好。本文旨在探讨南非城市中异性恋男性的 HIV 预防偏好，并研究青睐长效注射型 (LAI) PrEP 而非避孕套和口服 PrEP 的男性的需求和特征。
方法
在 178 名自我报告 HIV 阴性的异性恋男性中收集数据，在向他们提供示例产品和信息后，询问他们的偏好。使用多变量逻辑回归分析哪些特征与产品选择相关。
结果
48%（n=85）的参与者更喜欢 LAI PrEP，而 33%（n=58）和 20%（n=35）的参与者分别更喜欢口服 PrEP 和避孕套。有孩子（边际效应=0.22；95%CI [0.01, 0.44]）或具有更高风险态度得分（边际效应=0.03；95%CI [0.01, 0.06]）与选择 LAI PrEP 显著相关，而那些有未保护的肛交（边际效应=-0.42；95%CI [-0.57, -0.27]）和那些更关心预防其他性传播感染而不是 HIV 的人（边际效应=-0.42；95%CI [-0.60, -0.24]）似乎不太可能更喜欢 LAI PrEP。
结论
结果表明，南非城市中的异性恋男性对 LAI PrEP 的需求较高且理论上可接受，但与在男同性恋和双性恋男性和女性中进行的研究相比，愿意使用 LAI PrEP 的明确预测因素似乎较少。然而，这些发现有助于描绘撒哈拉以南非洲异性恋男性对新型基于抗逆转录病毒的预防措施的需求和决定因素，并为使用 LAI PrEP 与其他方法相结合设计未来 HIV 预防策略提供数据支持。
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