Hopital de Zone Allada, Allada, Benin.
Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada.
BMC Public Health. 2020 Aug 20;20(1):1267. doi: 10.1186/s12889-020-09363-4.
BACKGROUND: In Benin, men who have sex with men (MSM) do not always use condoms during anal sex. Pre-exposure prophylaxis (PrEP) using Truvada® (tenofovir disoproxil fumarate / emtricitabine) may be a complementary HIV prevention measure for MSM. This study aimed at identifying the potential facilitators and barriers to the use of PrEP. METHODS: This was a cross-sectional study conducted in 2018 among male-born MSM aged 18 years or older who reported being HIV-negative or unaware of their HIV status. The participants were recruited by the RDS technique (respondent driven sampling) in six cities of Benin. Logistic regression analyses, adapted to RDS statistical requirements, were performed to identify the factors associated with PrEP acceptability. RESULTS: Mean age of the 400 MSM recruited was 26.2 ± 5.0 years. PrEP was known by 50.7% of respondents. The intention to use PrEP was expressed by 90% of MSM. If PrEP effectiveness were 90% or more, 87.8% of the respondents thought they would decrease condom use. In multivariate analysis, the facilitators associated with PrEP acceptability were: not having to pay for PrEP (odds ratio (OR) = 2.39, 95% CI: 1.50-4.46) and its accessibility within MSM networks (OR = 9.82, 95% CI: 3.50-27.52). Only one barrier was significant: the concern that taking PrEP be perceived as marker of adopting HIV risky behaviors (OR = 0.11, 95% CI: 0.04-0.30). CONCLUSION: In Benin, not all MSM know about PrEP. But once well informed, the majority seems willing to use it if made available. The free availability of the drug and its accessibility in the MSM networks are important facilitators. The possibility of decrease in condom use should not be a barrier to the prescription of PrEP if made available.
背景:在贝宁,男男性行为者(MSM)在肛交时并不总是使用安全套。使用特鲁瓦达®(富马酸替诺福韦二吡呋酯/恩曲他滨)进行暴露前预防(PrEP)可能是 MSM 的一种补充 HIV 预防措施。本研究旨在确定 MSM 使用 PrEP 的潜在促进因素和障碍。 方法:这是 2018 年在六个贝宁城市进行的一项横断面研究,参与者为年龄在 18 岁或以上、报告 HIV 阴性或不知道 HIV 状况的男性出生的 MSM。参与者通过 RDS 技术(响应者驱动抽样)招募。采用适应 RDS 统计要求的逻辑回归分析,确定与 PrEP 可接受性相关的因素。 结果:招募的 400 名 MSM 的平均年龄为 26.2±5.0 岁。50.7%的受访者听说过 PrEP。90%的 MSM 表示有意使用 PrEP。如果 PrEP 的有效性为 90%或更高,87.8%的受访者认为他们会减少使用安全套。在多变量分析中,与 PrEP 可接受性相关的促进因素是:无需支付 PrEP 费用(优势比(OR)=2.39,95%置信区间:1.50-4.46)和在 MSM 网络内获得 PrEP(OR=9.82,95%置信区间:3.50-27.52)。只有一个障碍是显著的:担心服用 PrEP 会被视为采取 HIV 高危行为的标志(OR=0.11,95%置信区间:0.04-0.30)。 结论:在贝宁,并非所有 MSM 都了解 PrEP。但一旦得到充分的信息,大多数人如果有药,似乎愿意使用。药物的免费提供和在 MSM 网络中的可及性是重要的促进因素。如果提供 PrEP,避孕套使用减少的可能性不应成为处方的障碍。
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