Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
J Adolesc Health. 2020 Mar;66(3):268-274. doi: 10.1016/j.jadohealth.2019.08.014. Epub 2019 Oct 28.
PURPOSE: The aim of the study was to characterize perceived social support for young men and transgender women who have sex with men (YM/TWSM) taking HIV pre-exposure prophylaxis (PrEP). METHODS: Mixed-methods study of HIV-negative YM/TWSM of color prescribed oral PrEP. Participants completed egocentric network inventories characterizing their social support networks and identifying PrEP adherence support figures. A subset (n = 31) completed semistructured interviews exploring adherence support and qualities of PrEP support figures. We calculated proportions of role types (e.g., family), individuals disclosed to regarding PrEP use, and PrEP-supportive individuals within each participant network. Interviews were analyzed using an inductive approach. RESULTS: Participants (n = 50) were predominately African American men who have sex with men. Median age was 22 years (interquartile range: 20-23). Biologic family were the most common support figures, reported by 75% of participants (mean family proportion .37 [standard deviation (SD): .31]), followed by 67% reporting friends (mean friend proportion .38 [SD: .36]). Most network members were aware (mean disclosed proportion .74 [SD: .31]) and supportive (mean supportive proportion .87 [SD: .28]) of the participants' PrEP use. Nearly all (98%) participants identified ≥1 figure who provided adherence support; more often friends (48%) than family (36%). Participants characterized support as instrumental (e.g., transportation); emotional (e.g., affection); and social interaction (e.g., taking medication together). Key characteristics of PrEP support figures included closeness, dependability, and homophily (alikeness) with respect to sexual orientation. CONCLUSIONS: Although most YM/TWSM identified family in their support networks, friends were most often cited as PrEP adherence support figures. Interventions to increase PrEP adherence should consider integrated social network and family-based approaches.
目的:本研究旨在描述接受艾滋病毒暴露前预防(PrEP)的男男性行为者(YM/TWSM)和跨性别女性对社会支持的感知。
方法:对接受口服 PrEP 的有色 HIV 阴性 YM/TWSM 进行混合方法研究。参与者完成了以自我为中心的网络清单,描述了他们的社会支持网络,并确定了 PrEP 依从性支持者。其中一部分(n=31)完成了半结构化访谈,探讨了依从性支持和 PrEP 支持者的素质。我们计算了每种参与者网络中的角色类型(例如家庭)、向其透露 PrEP 使用情况的个人以及 PrEP 支持个人的比例。使用归纳法分析访谈数据。
结果:参与者(n=50)主要是与男性发生性关系的非裔美国男性,平均年龄为 22 岁(四分位距:20-23)。生物家庭是最常见的支持者,有 75%的参与者报告(平均家庭比例为.37[标准差(SD):.31]),其次是 67%的参与者报告朋友(平均朋友比例为.38[SD:.36])。大多数网络成员都知道(平均透露比例.74[SD:.31])并支持(平均支持比例.87[SD:.28])参与者的 PrEP 使用。几乎所有(98%)参与者都确定了≥1 名提供依从性支持的人;更多的是朋友(48%)而不是家人(36%)。参与者将支持描述为工具性的(例如,交通);情感性的(例如,情感);和社交互动(例如,一起服药)。PrEP 支持者的主要特征包括亲密、可靠和性取向的相似性(相似性)。
结论:尽管大多数 YM/TWSM 在他们的支持网络中确定了家庭,但朋友往往是 PrEP 依从性支持者。提高 PrEP 依从性的干预措施应考虑综合社会网络和以家庭为基础的方法。
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