Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
AIDS Care. 2023 Sep;35(9):1375-1385. doi: 10.1080/09540121.2023.2182872. Epub 2023 Mar 13.
Incarceration and HIV are a syndemic for US women, yet very few women who have experienced incarceration use pre-exposure prophylaxis (PrEP) for HIV. We conducted semi-structured interviews with 32 participants recruited by women who have experienced incarceration from their social networks, informed by the modified social ecological model for PrEP. Emergent themes from the interviews included individual-level (low personal HIV risk assessment, personal responsibility for HIV prevention, and decisions in addiction versus recovery), network-level (influential sex partners and the importance of trust, supportive treatment peers, and high-risk but indifferent drug use networks), community-level (stigma, and mitigation of stigma in supportive substance use disorder treatment environments), and public policy-level (incarceration and PrEP cost and access) determinants. PrEP interventions for women who have experienced incarceration and their networks will need to incorporate contingency planning into HIV risk assessment, navigate complex network dynamics, and be situated in trusted contexts to address structural barriers.
监禁和 HIV 是美国女性的综合征，但很少有经历过监禁的女性使用暴露前预防 (PrEP) 来预防 HIV。我们对 32 名参与者进行了半结构化访谈，这些参与者是由经历过监禁的女性从她们的社交网络中招募的，这些参与者的招募信息来源于 PrEP 的修正社会生态模型。访谈中出现的主题包括个人层面（个人 HIV 风险评估低、个人对 HIV 预防的责任、成瘾与康复之间的决策）、网络层面（有影响力的性伴侣以及信任的重要性、支持性的治疗同伴、高危但漠不关心的毒品使用网络）、社区层面（耻辱感，以及在支持性药物使用障碍治疗环境中减轻耻辱感）和公共政策层面（监禁和 PrEP 的成本和可及性）的决定因素。为经历过监禁的女性及其网络提供的 PrEP 干预措施将需要将应急计划纳入 HIV 风险评估，应对复杂的网络动态，并在可信赖的环境中解决结构性障碍。
