Villela Larissa M, Veloso Valdiléa G, Hoagland Brenda, Fernandes Nilo M, Kallas Esper G, Madruga Jose V, Moreira Ronaldo I, Grinsztejn Beatriz, De Boni Raquel B
37903Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI/FIOCRUZ), Rio de Janeiro, Brazil.
Centro de Referência e Treinamento em DST/AIDS, São Paulo, Brazil.
Int J STD AIDS. 2021 Aug;32(9):806-815. doi: 10.1177/0956462421992157. Epub 2021 Feb 20.
Pre-exposure prophylaxis (PrEP) prevents HIV infection among men who have sex with men (MSM) and transgender women (TGW) who are the groups that presents the high incidence risk in Brazil. This cross-sectional secondary analysis describes possible risk compensation, attitudes, and beliefs regarding the use of PrEP among 723 MSM and TGW evaluated in the study pre-screening phase. Possible risk compensation was reported by 31.6% individuals. In the multivariate model, factors that increased the likelihood of possible risk compensation were: self-referring as white vs. Black (AOR 2.05; CI 1.09, 3.85), perceiving high likelihood of getting HIV in next 12 months (AOR 1.78; CI 1.23, 2.56), being less afraid of HIV infection if using PrEP (AOR 1.93; CI 1.19, 3.14), feeling liberated to have more partners if using PrEP (AOR 2.93; CI 1.92, 4.49), and believing closest friends would use PrEP (AOR 2.51; CI 1.1, 5.71). We found that possible risk compensation was more common among individuals who presented high-risk perception for HIV infection, probably reflecting they feel at risk and could benefit from PrEP use.
暴露前预防（PrEP）可预防男男性行为者（MSM）和变性女性（TGW）感染艾滋病毒，这两类人群在巴西面临着高感染风险。这项横断面二次分析描述了在研究预筛查阶段评估的723名男男性行为者和变性女性中，关于使用PrEP可能存在的风险补偿、态度和信念。31.6%的个体报告了可能的风险补偿情况。在多变量模型中，增加可能风险补偿可能性的因素包括：自我认定为白人而非黑人（调整后比值比[AOR]为2.05；置信区间[CI]为1.09，3.85）、认为在未来12个月感染艾滋病毒的可能性高（AOR为1.78；CI为1.23，2.56）、使用PrEP时对艾滋病毒感染的恐惧较小（AOR为1.93；CI为1.19，3.14）、觉得使用PrEP后可以更自由地拥有更多性伴侣（AOR为2.93；CI为1.92，4.49）以及相信最亲密的朋友会使用PrEP（AOR为2.51；CI为1.1，5.71）。我们发现，可能的风险补偿在那些对艾滋病毒感染有高风险认知的个体中更为常见，这可能反映出他们觉得自己处于风险之中，并且可以从使用PrEP中获益。
