College of Nursing, the Ohio State University, Columbus, OH.
Infectious Disease Institute, the Ohio State University, Columbus, OH; and.
J Acquir Immune Defic Syndr. 2022 Oct 1;91(2):138-143. doi: 10.1097/QAI.0000000000003036.
Black and Hispanic/Latino sexual minority men and gender diverse (SMMGD) individuals report lower uptake and adherence to pre-exposure prophylaxis (PrEP) compared with White SMMGD. For some, the COVID-19 pandemic has resulted in reduced access to PrEP prescriptions and related changes to PrEP use, yet little is known how pandemic-related changes to PrEP access and sexual activity might influence sexually transmitted infection (STI) status and HIV seroconversion among SMMGD of color. We used data from 4 waves of a national study of Black and Hispanic/Latino SMMGD's HIV, PrEP, and health experiences to assess whether self-reported changes to sexual activity were associated with STI status, and whether self-reported changes to PrEP access were associated with HIV seroconversion. Those who reported greater impact to their sexual activity during the pandemic [adjusted odds ratio (aOR) = 1.24; 95% confidence interval (CI): 1.10 to 1.40] and a greater number of sexual partners (aOR = 1.29; 95% CI: 1.21 to 1.38) were more likely to report a positive STI test. In addition, we found that compared with those who did not report pandemic-related changes to PrEP access, those who did report changes to PrEP access had significantly higher odds of HIV seroconversion during the study period (aOR = 2.80; 95% CI: 1.02 to 7.68). These findings have implications for HIV and STI prevention and highlight the importance of novel interventions to improve PrEP access among Black and Hispanic/Latino SMMGD. Importantly, these findings also demonstrate the need to stay focused on key populations at risk of HIV infection during emerging public health crises to avoid an increase in rates of new diagnoses.
黑人和西班牙裔/拉丁裔性少数男性和性别多样化（SMMGD）个体报告称，与白人 SMMGD 相比，他们接受和坚持使用暴露前预防（PrEP）的比例较低。对于一些人来说，COVID-19 大流行导致 PrEP 处方的获取减少，以及 PrEP 使用的相关变化，但对于大流行期间 PrEP 获取和性行为的变化如何影响有色人种 SMMGD 的性传播感染（STI）状况和 HIV 血清转换，知之甚少。我们使用了一项针对黑人和西班牙裔/拉丁裔 SMMGD 的 HIV、PrEP 和健康经验的全国性研究的 4 个波次的数据，评估了自我报告的性行为变化是否与 STI 状况相关，以及自我报告的 PrEP 获取变化是否与 HIV 血清转换相关。那些报告在大流行期间性行为受到更大影响的人[调整后的优势比（aOR）=1.24；95%置信区间（CI）：1.10 至 1.40]和性伴侣数量更多的人[aOR=1.29；95%CI：1.21 至 1.38]更有可能报告阳性的 STI 检测结果。此外，我们发现与那些没有报告与大流行相关的 PrEP 获取变化的人相比，那些报告 PrEP 获取变化的人在研究期间 HIV 血清转换的几率显著更高（aOR=2.80；95%CI：1.02 至 7.68）。这些发现对 HIV 和 STI 预防具有影响，并强调了需要采取新的干预措施来改善黑人和西班牙裔/拉丁裔 SMMGD 的 PrEP 获取。重要的是，这些发现还表明，在出现新的公共卫生危机时，需要继续关注面临 HIV 感染风险的重点人群，以避免新诊断病例的增加。
