Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 N. Summit Avenue, Milwaukee, WI, 53202, USA.
School of Social Work, Rutgers University, New Brunswick, NJ, USA.
Prev Sci. 2022 Nov;23(8):1438-1447. doi: 10.1007/s11121-022-01372-6. Epub 2022 May 7.
Treatment as prevention and pre-exposure prophylaxis (PrEP) have reduced HIV transmission among sexual minority men (SMM). However, little is known about PrEP-related communication in serodiscordant partnerships. In 2015-2016, 965 US SMM living with HIV (M = 39; 63% White, 19% Black, 18% Latinx) enrolled in a year-long longitudinal study with surveys every 3 months (2,850 surveys). Multilevel models explored factors associated with PrEP-related communication with HIV-negative partners. Most participants (77%) reported PrEP-related communication. Participants were more likely to discuss PrEP during periods with more sexual partners, AOR = 2.89, p < .001, and group sex, AOR = 1.99, p = .001. Those with more partners on average, β = 0.48, p < .001, and those engaging in other drug use more frequently, β = 0.11, p = .002, were more likely to discuss PrEP. PrEP-related communication was more common for men who disclosed their HIV status, β = 0.22, p < .001, and who had undetectable viral loads, β = 0.25, p = .007. Communication was also more common for those with higher incomes, β = 0.12, p = .02, and from larger cities, β = 0.07, p = .048, and less common for Black participants, β = - 0.29, p = .003, and older participants, β = - 0.18, p < .001. PrEP-related communication increased over the course of the study, AOR = 1.16, p= .02. PrEP can confer additional HIV prevention benefits within serodiscordant partnerships, and future research should continue to explore the role PrEP plays in these partnerships.
治疗即预防和暴露前预防（PrEP）已经降低了性少数群体男性（SMM）中的 HIV 传播。然而，对于血清不一致伴侣关系中的 PrEP 相关沟通知之甚少。在 2015-2016 年，965 名美国与 HIV 共存的 SMM（M=39；63%为白人，19%为黑人，18%为拉丁裔）参加了一项为期一年的纵向研究，每 3 个月进行一次调查（2850 次调查）。多层次模型探讨了与 HIV 阴性伴侣进行 PrEP 相关沟通的相关因素。大多数参与者（77%）报告了 PrEP 相关沟通。参与者在性伴侣较多、AOR=2.89，p<.001 和群交、AOR=1.99，p=.001 期间更有可能讨论 PrEP。平均而言，性伴侣较多的参与者，β=0.48，p<.001，以及更频繁使用其他药物的参与者，β=0.11，p=.002，更有可能讨论 PrEP。那些透露 HIV 状况的参与者，β=0.22，p<.001，以及病毒载量无法检测到的参与者，β=0.25，p=.007，更有可能讨论 PrEP。收入较高的参与者，β=0.12，p=.02，来自较大城市的参与者，β=0.07，p=.048，更有可能进行 PrEP 相关沟通，而黑人参与者，β=−0.29，p=.003，以及年龄较大的参与者，β=−0.18，p<.001，进行 PrEP 相关沟通的可能性较小。在研究过程中，PrEP 相关沟通有所增加，AOR=1.16，p=0.02。PrEP 可以在血清不一致的伴侣关系中提供额外的 HIV 预防益处，未来的研究应继续探索 PrEP 在这些伴侣关系中的作用。
