School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA.
Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, 3550 Market St, Philadelphia, PA, 19104, USA.
AIDS Behav. 2022 Apr;26(4):1211-1221. doi: 10.1007/s10461-021-03476-6. Epub 2021 Sep 21.
Pre-exposure prophylaxis (PrEP) rollout efforts thus far have inadequately reached young people from underrepresented backgrounds. This study explores PrEP engagement among young Black and Latinx men who have sex with men, transgender women, and gender diverse individuals in three U.S. cities using an adapted PrEP continuum measure. We analyze data from the recruitment phase of an ongoing PrEP engagement intervention (n = 319) using partial proportional odds logistic regression. Participants reported high willingness and intention to use PrEP, yet most (82%) were not currently taking PrEP. Being insured (aOR = 2.95, 95%-CI = 1.60-5.49), having one or more PrEP users in one's sexual network (aOR = 4.19, 95%-CI = 2.61-6.79), and higher individual HIV risk scores (aOR = 1.62, 95%-CI = 1.34-1.97) were each associated with being further along the PrEP continuum. Strategies are needed to address barriers to healthcare access and leverage connections within social and sexual networks in order to bolster PrEP engagement among marginalized young people from diverse backgrounds.
迄今为止，暴露前预防 (PrEP) 的推广工作未能充分覆盖代表性不足的背景的年轻人。本研究使用经过改编的 PrEP 连续测量方法，探讨了来自美国三个城市的与男性发生性关系的年轻黑人、拉丁裔男性、跨性别女性和性别多样化人群对 PrEP 的参与情况。我们分析了正在进行的 PrEP 参与干预招募阶段的数据（n=319），使用部分比例优势逻辑回归进行分析。参与者报告了高度愿意和打算使用 PrEP，但大多数（82%）人目前没有服用 PrEP。有保险（aOR=2.95，95%CI=1.60-5.49）、性网络中存在一个或多个 PrEP 用户（aOR=4.19，95%CI=2.61-6.79）和更高的个体 HIV 风险评分（aOR=1.62，95%CI=1.34-1.97）均与 PrEP 连续体的进展有关。需要采取策略来解决医疗保健获取的障碍，并利用社会和性网络中的联系，以增强来自不同背景的边缘化年轻人对 PrEP 的参与。
