Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA.
J Racial Ethn Health Disparities. 2023 Apr;10(2):899-910. doi: 10.1007/s40615-022-01278-7. Epub 2022 Mar 15.
Pre-exposure prophylaxis (PrEP), a potent medication for HIV prevention, shows promise for reducing HIV disparities. However, PrEP is not equitably utilized by all races and ethnicities in the USA. Its uptake is especially low among African Americans, who are disproportionately impacted by HIV. Understanding factors influencing low PrEP uptake among diverse priority groups of African American young adults beyond gender and sexual minority groups (e.g., cisgender heterosexual people) may increase PrEP uptake. Data were from the Afya project, a study examining the use of PrEP for HIV prevention among multiple priority groups of African American young adults at heightened HIV risk, using Theory of Reasoned Action/Theory of Planned Behavior (TRA/TPB) as a theoretical framework. Eleven focus groups (N = 63) were conducted in Louisville, Kentucky from June to November 2018 with African American young adult priority groups (18-29 years old): men who have sex with men, transgender women, and cisgender heterosexual men and women demonstrating heightened sexual risk. Data were analyzed using constructivist grounded theory techniques. PrEP awareness, knowledge, perceived HIV risk and perceived need for PrEP (behavioral beliefs) and adherence beliefs (control beliefs), opinions of others (subjective norms), and confidence in ability to adhere to PrEP (perceived behavior controls) influenced acceptability of PrEP (participants' attitudes) and, in turn, influenced intention to use PrEP either negatively or positively. Thus, understanding factors that create reticence to PrEP use provides useful insight for tailoring outreach interventions towards African American young adults to improve PrEP uptake.
暴露前预防（PrEP）是一种用于预防 HIV 的有效药物，有望减少 HIV 差异。然而，在美国，并非所有种族和族裔都平等地使用 PrEP。非裔美国人对 PrEP 的接受程度尤其低，他们受到 HIV 的影响不成比例。了解影响不同非裔美国青年亚群体（如跨性别异性恋者）中 PrEP 接受率低的因素，除了性别和性少数群体之外，可能会增加 PrEP 的接受率。数据来自 Afya 项目，该项目研究了在 HIV 风险较高的多个非裔美国青年亚群体中使用 PrEP 预防 HIV 的情况，使用理性行动理论/计划行为理论（TRA/TPB）作为理论框架。2018 年 6 月至 11 月，在肯塔基州路易斯维尔市，对非裔美国青年亚群体（18-29 岁）进行了 11 次焦点小组（N=63），包括男男性行为者、跨性别女性和性风险较高的顺性别异性恋男性和女性。使用建构主义扎根理论技术对数据进行了分析。PrEP 意识、知识、感知 HIV 风险和 PrEP 需求（行为信念）以及依从信念（控制信念）、他人意见（主观规范）以及对坚持 PrEP 的信心（感知行为控制）影响 PrEP 的可接受性（参与者的态度），进而影响使用 PrEP 的意图，要么是负面的，要么是正面的。因此，了解导致对 PrEP 使用犹豫不决的因素，为针对非裔美国青年亚群体定制外展干预措施提供了有用的见解，以提高 PrEP 的接受率。
