School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
School of Global Public Health, New York University, New York, New York, USA.
BMJ Open. 2021 Jul 1;11(7):e048993. doi: 10.1136/bmjopen-2021-048993.
HIV transmission within serodifferent heterosexual couples plays a key role in sustaining the global HIV pandemic. In the USA, transmission within established mixed-status couples accounts for up to half of all new HIV infections among heterosexuals. Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention method, although underutilised among serodifferent couples. Moreover, there is a dearth of research on US HIV-serodifferent couples' perspectives and use of PrEP, alone or in combination with other prevention methods. In this paper, we describe the study protocol for the Magnetic Couples Study, designed to fill critical knowledge gaps regarding HIV-serodifferent heterosexual couples' perspectives, experiences and utilisation of PrEP.
The Magnetic Couples Study is a mixed methods prospective cohort study designed to describe temporal patterns and identify determinants at multiple levels (individual, couple, HCF) of PrEP outcomes along the care continuum (PrEP awareness, linkage, uptake, retention and medication adherence) among HIV-serodifferent heterosexual couples residing in New York City. The study will also examine clinical management of PrEP, side effects and changes in sexual-related and substance use-related behaviour. A prospective cohort of 230 mixed-status couples already on oral PrEP was recruited, with quarterly assessments over 18 months; in addition, a cross-sectional sample of 150 mixed-status couples not currently on PrEP was recruited. In-depth semistructured qualitative interviews were conducted with a subsample of 25 couples. Actor-partner interdependence modelling using multilevel analysis will be employed for the analysis of longitudinal dyadic data. Framework analysis will be used to analyse qualitative data. A parallel convergent design will be used for mixed methods integration.
The study was approved by the University of Rochester Institutional Review Board (RSRB00052766). Study findings will be disseminated to community members and providers and to researchers and policy makers.
在血清学不同的异性恋伴侣中，HIV 传播在维持全球 HIV 大流行中起着关键作用。在美国，在已建立的混合感染状态伴侣中传播，占所有新感染 HIV 的异性恋者的一半。口服 HIV 暴露前预防（PrEP）是一种非常有效的预防方法，但在血清学不同的伴侣中使用率较低。此外，关于美国 HIV 血清学不同的伴侣对 PrEP 的看法和使用情况，单独或与其他预防方法结合使用的研究很少。在本文中，我们描述了磁性伴侣研究的研究方案，旨在填补关于 HIV 血清学不同的异性恋伴侣对 PrEP 的看法、经验和使用情况的关键知识空白。
磁性伴侣研究是一项混合方法前瞻性队列研究，旨在描述沿护理连续体（PrEP 意识、衔接、采用、保留和药物依从性）的多个层面（个体、伴侣、HCF）中 PrEP 结局的时间模式，并确定决定因素，包括居住在纽约市的 HIV 血清学不同的异性恋伴侣。该研究还将检查 PrEP 的临床管理、副作用以及性行为和药物使用相关行为的变化。已经招募了 230 对正在接受口服 PrEP 的混合状态伴侣，进行了 18 个月的季度评估；此外，还招募了 150 对目前未接受 PrEP 的混合状态伴侣的横断面样本。对 25 对夫妇进行了半结构化深入访谈。使用多层次分析的演员-伙伴相互依存模型将用于分析纵向对偶数据。框架分析将用于分析定性数据。将使用并行收敛设计进行混合方法整合。
该研究已获得罗切斯特大学机构审查委员会（RSRB00052766）的批准。研究结果将传播给社区成员和提供者，以及研究人员和政策制定者。
