Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
AIDS Care. 2021 Feb;33(2):219-228. doi: 10.1080/09540121.2020.1762067. Epub 2020 May 14.
Women with syndemic conditions, i.e., two or more co-occurring epidemics, are at elevated risk for HIV acquisition and are therefore prime candidates for pre-exposure prophylaxis (PrEP). However, PrEP uptake remains low among women, especially among Black and Hispanic women. This study examined associations of syndemic conditions with PrEP attitudes and HIV risk among women, and the moderating effect of race and ethnicity. In 2017, 271 non-Hispanic Black, non-Hispanic White, and Hispanic, PrEP-eligible women engaged in care at Planned Parenthood in the northeastern region of the U.S. completed an online survey. Participants reported syndemic conditions (i.e., intimate partner violence, depression, substance use), PrEP attitudes (e.g., PrEP interest), HIV sexual risk (e.g., multiple male sexual partners), and sociodemographics. Structural equation modeling was used to examine the effects of syndemic conditions on PrEP attitudes and HIV risk, and the moderating effect of race and ethnicity. Women with more syndemic conditions had a higher odds of reporting multiple male sexual partners. Syndemic conditions were positively associated with PrEP attitudes for Hispanic women than non-Hispanic Black and White women. Women with syndemic conditions, particularly Hispanic women, may be receptive to interventions promoting PrEP.
患有综合征的女性,即同时患有两种或两种以上流行病的女性,感染艾滋病毒的风险较高,因此是暴露前预防(PrEP)的主要候选人群。然而,PrEP 的使用率在女性中仍然较低,尤其是在黑人和西班牙裔女性中。本研究调查了综合征状况与女性对 PrEP 的态度和艾滋病毒风险之间的关联,以及种族和民族的调节作用。2017 年,271 名符合 PrEP 条件的非西班牙裔黑人、非西班牙裔白人和西班牙裔女性在美国东北部的计划生育参与了护理,并完成了一项在线调查。参与者报告了综合征状况(即亲密伴侣暴力、抑郁、药物使用)、PrEP 态度(例如,PrEP 兴趣)、艾滋病毒性风险(例如,多个男性性伴侣)和社会人口统计学特征。结构方程模型用于检查综合征状况对 PrEP 态度和艾滋病毒风险的影响,以及种族和民族的调节作用。患有更多综合征的女性报告多个男性性伴侣的可能性更高。与非西班牙裔黑人女性和西班牙裔女性相比,西班牙裔女性的综合征状况与 PrEP 态度呈正相关。患有综合征的女性,尤其是西班牙裔女性,可能更容易接受促进 PrEP 的干预措施。