Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave. 14th Floor, Chicago, IL, 60611, USA.
J Racial Ethn Health Disparities. 2024 Aug;11(4):2093-2102. doi: 10.1007/s40615-023-01678-3. Epub 2023 Jun 22.
BACKGROUND: Latino men who have sex with men (LMSM) are disproportionally affected by HIV infections in the USA. The uptake rate of pre-exposure prophylaxis (PrEP) for HIV prevention has remained low among LMSM. Long-acting injectable PrEP (LAI-PrEP) may have the potential to improve structural, behavioral, and cognitive barriers to adherence. Given the potential benefits of LAI-PrEP and the limited data with this population, the aim of our study was to explore experiences and attitudes of LAI-PrEP among LMSM and identify implementation barriers compared to the standard oral presentation, align proposed implementation strategies, and propose outcomes to monitor and assess impact. METHODS: In this qualitative study, guided by the Consolidated Framework for Implementation Research, we explored health care providers perspectives on facilitators and barriers to LAI-PrEP implementation strategies for LMSM. Interviews were recorded, transcribed, and analyzed using thematic content analysis. RESULTS: Fear of immigration policies, ability to conceal PrEP medication, health insurance coverage, health information fatigue, lack of culturally adapted information, and provider's lack of knowledge were among the main barriers to LAI-PrEP. Most providers discussed the need for adapted and/or tailored training materials for and suggested designing marketing materials and specific clinical recommendations for LAI-PrEP. CONCLUSION: In order to ensure an effective adaptation process that encompasses local and national goals of HIV prevention, future interventions should be designed in a way that incorporates culturally relevant information for LMSM. This study provides an implementation research logic model to guide future studies.
背景:在美国,男男性行为者(MSM)中的拉丁裔男性受到 HIV 感染的影响不成比例。预防 HIV 的暴露前预防(PrEP)的采用率在 MSM 中仍然很低。长效注射型 PrEP(LAI-PrEP)可能有潜力改善坚持预防的结构、行为和认知障碍。鉴于 LAI-PrEP 的潜在益处,以及针对该人群的数据有限,我们的研究旨在探索 LAI-PrEP 在 MSM 中的经验和态度,并确定与标准口服制剂相比的实施障碍,调整拟议的实施策略,并提出监测和评估影响的结果。
方法:在这项定性研究中,我们遵循整合实施研究框架,探讨了医疗保健提供者对 LAI-PrEP 实施策略的看法,探讨了促进因素和障碍。采访记录、转录并使用主题内容分析进行分析。
结果:对移民政策的恐惧、隐藏 PrEP 药物的能力、医疗保险覆盖范围、健康信息疲劳、缺乏文化适应信息以及提供者缺乏知识是 LAI-PrEP 的主要障碍之一。大多数提供者讨论了为 LAI-PrEP 制定适应和/或定制培训材料的必要性,并建议设计营销材料和具体的临床建议。
结论:为了确保有效的适应过程,包括 HIV 预防的地方和国家目标,未来的干预措施应该以一种为 MSM 提供文化相关信息的方式设计。本研究提供了一个实施研究逻辑模型,以指导未来的研究。
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