男男性行为者及其性伴从不情愿使用到倡导使用 HIV 暴露前预防用药的转变过程：一项纵向混合方法研究。

How Male Sex Workers and Their Clients Shifted from Reluctance About HIV Pre-exposure Prophylaxis to Advocating for Its Use: A Longitudinal Mixed Methods Study.

机构信息

Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, UNSW, High Street, Kensington, NSW, 2052, Australia.

Centre for Social Research in Health, UNSW Sydney, Level 2, John Goodsell Building, UNSW, Kensington, NSW, 2052, Australia.

出版信息

AIDS Behav. 2020 Mar;24(3):782-790. doi: 10.1007/s10461-019-02618-1.

DOI:10.1007/s10461-019-02618-1

PMID:31367966

Abstract

We assessed individual and collective responses to HIV pre-exposure prophylaxis ('PrEP') among a network of male sex workers and clients. From 2011 to May 2017, keyword searches on an online discussion forum identified 668 posts that referenced PrEP. We conducted four analyses: (i) discourse analysis identifying reactions to PrEP, (ii) thematic analysis constructing rhetorical strategies, (iii) content analysis comparing discursive positions and rhetorical strategies, and (iv) longitudinal analyses assessing trends over time. Forum posts adopted one of three discursive positions (reluctance, interest, advocacy), drawing upon four non-exclusive strategies (deference to experts and evidence, acknowledging personal and shared experiences, establishing philosophical arguments, engaging in speculation). Posts from sex workers were more likely than clients to be supportive of PrEP (96% vs. 42%; χ = 18.46, p < 0.001) while over time this network moved from being predominantly reluctant about PrEP (61% of posts in 2012) to advocating for its use (65% of posts in 2017; Z = 5.01, p < 0.001).

摘要

我们评估了男男性行为者和客户网络中对艾滋病毒暴露前预防（“PrEP”）的个体和集体反应。从 2011 年到 2017 年 5 月，在线讨论论坛上的关键词搜索确定了 668 篇提到 PrEP 的帖子。我们进行了四项分析：（i）话语分析，确定对 PrEP 的反应，（ii）主题分析，构建修辞策略，（iii）内容分析，比较话语立场和修辞策略，以及（iv）纵向分析，评估随时间的趋势。论坛帖子采用了三种话语立场之一（不情愿、感兴趣、支持），采用了四种非排他性策略（尊重专家和证据、承认个人和共同经验、建立哲学论点、进行推测）。性工作者的帖子比客户更支持 PrEP（96%比 42%；χ=18.46，p<0.001），而随着时间的推移，该网络从主要对 PrEP 持不情愿态度（2012 年的帖子中有 61%）转变为支持其使用（2017 年的帖子中有 65%；Z=5.01，p<0.001）。