Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada.
Sexual Health and Harm Reduction Services, Ottawa Public Health, Ottawa, ON, Canada.
BMC Infect Dis. 2022 Feb 28;22(1):196. doi: 10.1186/s12879-022-07146-3.
While HIV pre-exposure prophylaxis (PrEP) has become more readily available in Canada, its uptake among HIV priority populations continues to be affected by system-level and individual factors. Such impediments relate to challenges by healthcare providers in assessing HIV-related risk and variability in patients' motivations for PrEP initiation and continued engagement in care.
In Ottawa, Canada, a group of researchers implemented Canada's first nurse-led HIV prevention program, known as PrEP-RN. As part of this pilot, qualitative interviews were completed with fourteen patients who had accessed PrEP-RN. The purpose of these interviews was to understand participants' perspectives related to HIV prevention and experiences accessing care through a nurse-led service. Interviews were analyzed using thematic analysis, which were organized into the two major themes of (1) motivations for PrEP initiation and (2) beliefs about the benefits of PrEP.
Findings revealed participants' motivations for PrEP differed from healthcare provider's views of risk, which were influenced by external life factors and personal perceptions of risk. In addition, participants discussed the benefits of PrEP in terms of its ability to manage their potential mistrust of sexual partners, control their sexual health, and liberate fears and anxieties related to HIV.
Based on these findings, health and allied providers should consider incorporating individual motivations and beliefs into patient education and counselling about PrEP to better target HIV prevention care at persons are at elevated risk of HIV. These perspectives could also be used to re-structure web and social media campaigns to increase PrEP uptake among HIV priority populations.
尽管加拿大更容易获得艾滋病毒暴露前预防 (PrEP)，但艾滋病毒重点人群对其的接受率仍受到系统和个人因素的影响。这些障碍与医疗保健提供者在评估艾滋病毒相关风险以及患者启动 PrEP 和持续参与护理的动机的可变性方面面临的挑战有关。
在加拿大渥太华，一组研究人员实施了加拿大第一个由护士主导的艾滋病毒预防计划，称为 PrEP-RN。作为该试点的一部分，对 14 名已经获得 PrEP-RN 的患者进行了定性访谈。这些访谈的目的是了解参与者对艾滋病毒预防的看法以及通过护士主导的服务获取护理的经验。使用主题分析对访谈进行分析，这些分析分为两个主要主题：（1）启动 PrEP 的动机；（2）对 PrEP 益处的看法。
研究结果显示，参与者启动 PrEP 的动机与医疗保健提供者对风险的看法不同，后者受到外部生活因素和个人对风险的看法的影响。此外，参与者还讨论了 PrEP 的好处，即它能够帮助他们管理对性伴侣的潜在不信任、控制自己的性健康，并消除与艾滋病毒相关的恐惧和焦虑。
基于这些发现，卫生和相关提供者应考虑将个人动机和信念纳入有关 PrEP 的患者教育和咨询中，以便更好地针对艾滋病毒高风险人群进行艾滋病毒预防护理。这些观点也可以用于重新构建网络和社交媒体活动，以增加艾滋病毒重点人群对 PrEP 的接受率。
