Jansen van Vuuren Claudia J, Lewis Lara, Harkoo Ishana, Dawood Halima, Mansoor Leila E
Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
AIDS Behav. 2023 Nov;27(11):3596-3602. doi: 10.1007/s10461-023-04072-6. Epub 2023 May 23.
New pre-exposure prophylaxis (PrEP) strategies tailored to the needs and expectations of individuals at risk of HIV acquisition are needed. In the CAPRISA 082 prospective cohort study in KwaZulu-Natal, South Africa, sexually active women aged 18 to 30 reported, through interviewer-administered questionnaires, on their prior contraceptive experience and interest in both approved and potential future PrEP dosage forms (oral PrEP, long-acting injectable PrEP, and PrEP implants) between March 2016 and February 2018. Univariable and multivariable Poisson regression models with robust standard errors were used to detect associations between women's prior and current contraceptive use and interest in PrEP options. Of 425 women enrolled, 381 (89.6%) had used at least one modern female contraceptive method previously, with injectable depot medroxyprogesterone acetate (DMPA) being used by 79.8% (n = 339). Women were more likely to show interest in a future PrEP implant if they were currently using (aRR 2.1, CI 1.43-3.07, p = 0.0001) or had ever used (aRR 1.65, CI 1.14-2.40, p = 0.0087) a contraceptive implant, and were more likely to choose an implant as their first choice method than the implant-naïve (current users aRR 3.2, CI 1.79-5.73, p < 0.0001; "ever" users aRR 2.12, CI 1.16-3.86, p = 0.0142). Women were more interested in injectable PrEP if they had used injectable contraceptives (current users aRR 1.24, CI 1.06-1.46, p = 0.0088; "ever" users aRR 1.72, CI 1.20-2.48, p = 0.0033); and were more interested in oral PrEP if they had ever used oral contraceptives (aRR 1.3, CI 1.06-1.59, p = 0.0114). This apparent relationship between women's contraceptive experience and their interest in novel forms of PrEP in an equivalent dosage form may play a future role in strengthening HIV prevention efforts in women at high risk of HIV acquisition.
需要针对有感染艾滋病毒风险的个人的需求和期望制定新的暴露前预防(PrEP)策略。在南非夸祖鲁-纳塔尔省进行的CAPRISA 082前瞻性队列研究中,18至30岁有性行为的女性通过访员管理的问卷,报告了她们2016年3月至2018年2月期间先前的避孕经历以及对已批准和未来可能的PrEP剂型(口服PrEP、长效注射用PrEP和PrEP植入剂)的兴趣。使用具有稳健标准误差的单变量和多变量泊松回归模型来检测女性先前和当前的避孕使用情况与对PrEP选项的兴趣之间的关联。在425名登记的女性中,381名(89.6%)此前至少使用过一种现代女性避孕方法,其中79.8%(n = 339)使用过醋酸甲羟孕酮长效注射剂(DMPA)。如果女性目前正在使用(调整后风险比[aRR] 2.1,置信区间[CI] 1.43 - 3.07,p = 0.0001)或曾经使用过(aRR 1.65,CI 1.14 - 2.40,p = 0.0087)避孕植入剂,那么她们对未来的PrEP植入剂更有可能表现出兴趣,并且与从未使用过植入剂的女性相比,她们更有可能选择植入剂作为首选方法(当前使用者aRR 3.2,CI 1.79 - 5.73,p < 0.0001;“曾经”使用者aRR 2.12,CI 1.16 - 3.86,p = 0.
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