黑人女性中预防暴露前预防措施的采纳的障碍和促进因素：基于社会生态学模型的定性分析。

Barriers and Facilitators to Pre-exposure Prophylaxis Uptake Among Black Women: A Qualitative Analysis Guided by a Socioecological Model.

机构信息

Alexa B. D'Angelo, MPH, is a Project Coordinator and PhD Student, CUNY Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, New York, New York, USA. Leah N. Davis Ewart, MPH, CHES, is a PhD Student, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA. Juline Koken, PhD, is an Associate Professor, Department of Health Sciences, LaGuardia Community College of CUNY, Long Island City, New York, USA. David Bimbi, PhD, is a Professor, Department of Health Sciences, LaGuardia Community College of CUNY, Long Island City, New York, USA. Justin T. Brown, PhD, MPH, is an Assistant Professor and Executive Director, Department of Health Sciences, The Center for LGBTQ Studies (CLAGS), LaGuardia Community College of CUNY, Long Island City, New York, USA. Christian Grov, PhD, MPH, is a Professor, Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA.

出版信息

J Assoc Nurses AIDS Care. 2021;32(4):481-494. doi: 10.1097/JNC.0000000000000241.

DOI:10.1097/JNC.0000000000000241

PMID:34171885

Abstract

Black women experience disparities in HIV incidence. Pre-exposure prophylaxis (PrEP) is a once-daily pill that can prevent HIV transmission. To enhance PrEP uptake among Black women, it is essential to examine their perceptions of PrEP. In 2018, 33 Black women in New York City completed interviews about their attitudes, knowledge, and perceived barriers and facilitators to PrEP use. Emergent themes were organized using a socioecological model. Participants identified barriers at the sociocultural level, including stigma, medical mistrust, and health care avoidance. At the community level, health care access issues and limited community knowledge were reported. Partner-level barriers included trust in partners and meaning attributed to PrEP use within the context of monogamy. Individual-level barriers included low perceived risk and concerns about PrEP's safety and efficacy. Our findings can inform future PrEP research with Black women, as well as PrEP implementation efforts aimed at increasing uptake among this population.

摘要

黑人女性在 HIV 发病率方面存在差异。暴露前预防（PrEP）是一种每日一次的药丸，可以预防 HIV 传播。为了提高黑人女性对 PrEP 的接受程度，必须检查她们对 PrEP 的看法。2018 年，纽约市的 33 名黑人女性完成了关于她们对 PrEP 使用的态度、知识以及感知障碍和促进因素的访谈。使用社会生态学模型对出现的主题进行了组织。参与者确定了社会文化层面的障碍，包括污名化、医疗不信任和回避医疗保健。在社区层面，报告了医疗保健获取问题和社区知识有限。伙伴层面的障碍包括对伴侣的信任以及在一夫一妻制背景下赋予 PrEP 使用的意义。个人层面的障碍包括低风险感知和对 PrEP 的安全性和有效性的担忧。我们的研究结果可以为未来针对黑人女性的 PrEP 研究以及旨在提高该人群接受度的 PrEP 实施工作提供信息。