Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and the Carolina Population Center, Chapel Hill, North Carolina.
Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland and the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
AIDS Educ Prev. 2021 Feb;33(1):16-32. doi: 10.1521/aeap.2021.33.1.16.
Pre-exposure prophylaxis (PrEP) can reduce the risk of HIV infection by over 90% among those at high risk via sexual transmission. PrEP acceptance and adherence remains low among those at highest risk of HIV, including Black men who have sex with men (MSM) in the southern U.S. This community-based participatory research project explored Black MSM's experiences with PrEP in North Carolina through photovoice, a methodology using photography and discussion. Our findings highlighted challenges and opportunities with PrEP, including intersectional stigma, the need for improved patient-provider education, and the role of community-based organizations in closing patient-provider gaps. This work is a first step towards understanding the daily lives of Black MSM on PrEP in the Triangle Region of North Carolina, including barriers and facilitators to PrEP use. Implications for public health practice highlight the need for conducting community-level interventions, integrating PrEP into primary care, and normalizing PrEP through community conversations.
暴露前预防 (PrEP) 可以通过性传播将高风险人群的 HIV 感染风险降低 90% 以上。在美国南部，包括与男性发生性关系的黑人男同性恋者 (MSM) 在内的 HIV 高危人群中，PrEP 的接受率和依从率仍然很低。本社区参与式研究项目通过摄影和讨论的方法——即摄影心声法，探索了北卡罗来纳州黑人 MSM 对 PrEP 的体验。我们的研究结果强调了 PrEP 面临的挑战和机遇，包括交叉污名、需要改进医患教育以及社区组织在缩小医患差距方面的作用。这项工作是了解北卡罗来纳州三角地区黑人 MSM 接受 PrEP 情况的第一步，包括 PrEP 使用的障碍和促进因素。对公共卫生实践的影响强调需要开展社区层面的干预措施，将 PrEP 纳入初级保健，并通过社区对话使 PrEP 正常化。
