Department of Medicine, Health and Society, Vanderbilt University, Nashville, TN 37235, USA.
Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA.
Int J Environ Res Public Health. 2022 Aug 24;19(17):10534. doi: 10.3390/ijerph191710534.
One of the most significant innovations in HIV prevention is the use of HIV treatment to prevent HIV transmission. This information has been disseminated as the "Undetectable = Untransmittable" (U = U) message. Despite evidence of effectiveness, U = U awareness, belief, and understanding remains limited in some communities. In this study, we examine whether having an LGBTQ affirming healthcare provider increases U = U awareness, belief, and understanding among midlife and older gay and bisexual men in the US south, an understudied and underserved population and region where new HIV infections are increasing. We used data from the Vanderbilt University Social Networks Aging and Policy Study (VUSNAPS) on sexual minority men aged 50 to 76 from four southern US states collected in 2020-2021. We found that only one in four men reported prior awareness of U = U, but awareness was higher among men who have an LGBTQ affirming provider. Among HIV negative men, those with an affirming provider were more likely to believe and understand U = U, have more accurate risk perception, and have ever tested for HIV. Improving access to LGBTQ affirming healthcare may improve U = U awareness, belief, and understanding, which could help to curb HIV transmission in the US south.
HIV 预防领域的一项重大创新是使用 HIV 治疗来预防 HIV 传播。这一信息被宣传为“检测不到=不传播”（U = U）的信息。尽管有证据表明其有效，但 U = U 的知晓率、信念和理解在某些社区仍然有限。在这项研究中，我们研究了在美国南部，拥有一名 LGBTQ 友好的医疗服务提供者是否会增加中年和老年男同性恋和双性恋者对 U = U 的知晓率、信念和理解，这是一个研究不足和服务不足的人群和地区，新的 HIV 感染正在增加。我们使用了范德比尔特大学社会网络老龄化和政策研究（VUSNAPS）的数据，该研究于 2020 年至 2021 年期间在四个美国南部州对 50 至 76 岁的性少数男性进行了调查。我们发现，只有四分之一的男性报告说之前听说过 U = U，但在拥有 LGBTQ 友好提供者的男性中，这一比例更高。在 HIV 阴性男性中，那些有 LGBTQ 友好提供者的男性更有可能相信和理解 U = U，对风险的认知更准确，并且曾经接受过 HIV 检测。增加获得 LGBTQ 友好医疗服务的机会可能会提高 U = U 的知晓率、信念和理解，从而有助于遏制美国南部的 HIV 传播。
