Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, NC, USA.
Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, NC, USA.
Cult Health Sex. 2023 Jan;25(1):110-125. doi: 10.1080/13691058.2021.2023760. Epub 2022 Jan 11.
Women who have experienced incarceration face a disproportionately high risk of acquiring HIV. Despite efficacy of pre-exposure prophylaxis (PrEP) for HIV, very few women with incarceration histories are using PrEP. Our objective was to learn how sexual, drug-use and social relationships shape decisions about PrEP among women who have experienced incarceration. We used an inductive approach to analyse data from four focus groups undertaken with women who had previously experienced incarceration recruited from three community-based organisations. We identified public policy (medical distrust, lack of prevention in prisons and jails, and cost and coverage of PrEP); community (incarceration stigma, gossip as prevention); social and sexual network (positive peer and parenting relationships, distrust of sexual partners, and networks as a source of risk); and individual-level (active addiction or recovery, change after incarceration, and medical concerns) factors influencing the use of PrEP. Actions and interventions to improve PrEP uptake among women who have experienced incarceration must take account of the multilevel context of HIV prevention decisions.
曾被监禁的女性感染艾滋病毒的风险极高。尽管暴露前预防（PrEP）对艾滋病毒有疗效，但很少有曾有监禁史的女性使用 PrEP。我们的目的是了解曾被监禁的女性在决定使用 PrEP 时，性、药物使用和社会关系是如何影响她们的。我们采用归纳法分析了从三个社区组织招募的曾有监禁史的女性参加的四个焦点小组的数据。我们确定了公共政策（医疗不信任、监狱和拘留所缺乏预防措施，以及 PrEP 的费用和覆盖范围）；社区（监禁耻辱、八卦作为预防措施）；社会和性网络（积极的同伴和父母关系、对性伴侣的不信任、以及网络作为风险源）；以及个体层面（积极的毒瘾或康复、监禁后的改变、以及医疗问题）因素影响 PrEP 的使用。为了提高曾被监禁的女性使用 PrEP 的比例，必须考虑到 HIV 预防决策的多层次背景。
