Meyers Kathrine, Price Devon, Golub Sarit
Aaron Diamond AIDS Research Center Department of Psychology, Hunter College of the City University of New York PhD Program in Basic and Applied Social Psychology, Graduate Center of the City University of New York, New York, New York, USA.
Curr Opin HIV AIDS. 2020 Jan;15(1):66-72. doi: 10.1097/COH.0000000000000596.
The sociobehavioral research agenda for HIV prevention urgently needs to progress beyond research on end user preferences to examine how to best support patient access, engagement, and choice in the rollout of long-acting modalities. We outline critical challenges for an era of choice in biomedical prevention that could benefit from the rigorous application of sociobehavioral research methods.
Research in three areas could accelerate implementation of long-acting antiretrovirals for prevention: integrating dual process models into research on patient decision-making and behavior; identifying strategies that mitigate against unconscious and implicit biases in provider decision-making and behavior; and developing tools to support patient-centered communication that incorporate research in both of the first two areas.
We encourage the development of dual process models and measures to better understand patient behavior, including behavior related to initiating biomedical prevention, choice of prevention strategy, switching among strategies, and discontinuation. Second, there is the need to develop intervention research that targets provider behavior. Finally, we call for research to inform patient-centered communication tools that integrate an understanding of affective drivers of preexposure prophylaxis (PrEP) decision-making and protect against implicit bias in provider recommendations related to PrEP.
艾滋病预防的社会行为研究议程迫切需要从终端用户偏好研究进一步拓展,以探讨如何在长效预防方式的推广中更好地支持患者获取、参与和选择。我们概述了生物医学预防选择时代面临的关键挑战,这些挑战可通过严格应用社会行为研究方法得到改善。
三个领域的研究可加速长效抗逆转录病毒药物预防的实施:将双加工模型整合到患者决策和行为研究中;确定减轻医疗服务提供者决策和行为中无意识及隐性偏见的策略;开发支持以患者为中心沟通的工具,该工具应融合前两个领域的研究成果。
我们鼓励开发双加工模型和测量方法,以更好地理解患者行为,包括与启动生物医学预防、预防策略选择、策略转换及停药相关的行为。其次,需要开展针对医疗服务提供者行为的干预研究。最后,我们呼吁开展相关研究,以为以研究为依据的、以患者为中心的沟通工具,这些工具应整合对暴露前预防(PrEP)决策情感驱动因素的理解,并防止医疗服务提供者在PrEP相关建议中出现隐性偏见。