Hospital of the University of Pennsylvania, Philadelphia.
Boston Medical Center, Boston.
Glob Public Health. 2020 Sep;15(9):1337-1348. doi: 10.1080/17441692.2020.1744680. Epub 2020 Mar 24.
Gaps persist in HIV testing, treatment, and prevention services for men, leading to higher attributable mortality compared to women. We sought to characterise HIV prevention knowledge, risk behaviours, and interest in pre-exposure prophylaxis (PrEP) among young men in rural South Africa.
We conducted interviews with HIV-negative heterosexual men which were thematically analysed to identify key themes.
Among 31 participants, median age was 26 (IQR23-31), 77% were unemployed, 52% reported previous STI, 84% reported casual sexual partners. Men acknowledged inconsistent condom use with multiple partners, reporting high-risk sexual behaviour despite recognised risk. Mistrust between partners was common. Respondents reported willingness to take PrEP to protect themselves and their partner, though anticipated stigma and structural barriers. Men worried that if their female partner had PrEP, she would become sexually active with others.
In rural South Africa, young heterosexual men acknowledged high HIV-risk behaviour, expressed concern about acquiring HIV, and recognised the value of PrEP. Men were often not supportive of their female partners taking PrEP. Implementing HIV prevention services needs to incorporate young men's perspectives and may require gender-specific interventions, including addressing stigma, differentiated service delivery models such as community-based services or adapting facility services to target men.
与女性相比，男性在 HIV 检测、治疗和预防服务方面仍存在差距，这导致了更高的可归因死亡率。我们旨在描述南非农村地区年轻男性的 HIV 预防知识、风险行为以及对暴露前预防（PrEP）的兴趣。
我们对 HIV 阴性的异性恋男性进行了访谈，并对访谈内容进行了主题分析，以确定关键主题。
在 31 名参与者中，中位数年龄为 26 岁（IQR23-31），77%的人失业，52%的人报告曾患有性传播感染，84%的人报告有偶然的性伴侣。男性承认与多个伴侣发生性行为时经常不使用安全套，尽管他们认识到存在风险，但仍存在高风险性行为。伴侣之间缺乏信任很常见。受访者表示愿意服用 PrEP 来保护自己和伴侣，但他们担心会面临污名化和结构性障碍。男性担心如果他们的女性伴侣服用 PrEP，她会与他人发生性行为。
在南非农村地区，年轻的异性恋男性承认存在高 HIV 风险行为，对感染 HIV 表示担忧，并认识到 PrEP 的价值。男性通常不支持他们的女性伴侣服用 PrEP。实施 HIV 预防服务需要纳入年轻男性的观点，可能需要采取性别特定的干预措施，包括解决污名化问题、提供差异化的服务交付模式，如社区为基础的服务，或调整机构服务以针对男性。
