Département Des Maladies Infectieuses, Centre Hospitalier Universitaire, Montpellier, France.
UMI 233/INSERM U1175, Université de Montpellier, Montpellier, France.
AIDS Res Ther. 2021 Jan 7;18(1):2. doi: 10.1186/s12981-020-00327-7.
Pre-exposure prophylaxis (PrEP) for HIV is instrumental in the prevention of HIV for HIV-uninfected persons, by drastically reducing the risk of acquisition in the case of high-risk exposures. Despite its demonstrated efficacy, it remained under-prescribed in France until 2018. The principal aim of this study was to understand the motivations of Men who have Sex with Men (MSM) who started using PrEP in Montpellier, France.
A phenomenological study was undertaken, using semi-structured interviews with twelve participants attending the University Hospital of Montpellier for PrEP. Interviews were analysed by means of triangulation up to the point of theoretical saturation, using a semio-pragmatic method.
Fear of HIV infection, personalised regular follow-up, and the wish to take care of one's health were the primary motivational factors. PrEP allows for a better sexual life restoring a sense of freedom despite the risks of STI, deemed manageable by PrEPers. PrEP does not modify long-term risk-taking behaviours but helps them better live their own sexuality and guides them towards a responsible approach to sexuality. Unclear information on PrEP, delivered by their family doctor, public campaigns or the media, leads to misrepresentations or negative social representation, including within the MSM community, which may delay its implementation.
Fear of HIV infection and the benefits of regular medical follow-up to take care of one's health were motivational factors of importance for the use of PrEP by MSM in this study. PrEP transforms all existential dimensions of their lived experience, improving sexual identity and happiness. There is a need to improve professional awareness of the effectiveness of PrEP and to develop a patient centered approach, to disseminate information more widely to the general public and among MSM to reduce stigmatisation.
暴露前预防（PrEP）对于未感染 HIV 的人群预防 HIV 非常有效，可以大大降低高危暴露情况下的感染风险。尽管其已被证实有效，但直到 2018 年法国的 PrEP 处方量仍然很低。本研究的主要目的是了解在法国蒙彼利埃开始使用 PrEP 的男男性行为者（MSM）的动机。
采用现象学研究方法，对 12 名在蒙彼利埃大学医院接受 PrEP 的参与者进行半结构式访谈。使用半语用学方法进行三角分析，直到达到理论饱和，对访谈进行分析。
对 HIV 感染的恐惧、个性化的定期随访以及对健康的关注是主要的动机因素。PrEP 允许更好的性生活，恢复自由感，尽管存在性传播感染（STI）风险，但 PrEP 者认为这些风险是可以控制的。PrEP 不会改变长期的高风险行为，但可以帮助他们更好地享受自己的性行为，并引导他们采取负责任的性行为态度。对 PrEP 的信息了解不清，包括家庭医生、公共宣传活动或媒体提供的信息，导致了误解或负面的社会代表性，包括在 MSM 群体中，这可能会延迟其实施。
对 HIV 感染的恐惧和定期医疗随访以保持健康的好处是本研究中 MSM 使用 PrEP 的重要动机因素。PrEP 改变了他们生活经历的所有存在维度，改善了性认同和幸福感。需要提高专业人员对 PrEP 有效性的认识，并发展以患者为中心的方法，更广泛地向公众和 MSM 传播信息，以减少污名化。
