Behavioral, Epidemiological, Clinical Sciences Division, FHI 360, Durham, NC, USA.
Global Health Institute, Duke University, Durham, NC, USA.
Clin Nurs Res. 2023 Sep;32(7):1046-1056. doi: 10.1177/10547738231184295. Epub 2023 Jul 4.
Stigmatization on the basis of race, sexuality, gender identity, and/or use of pre-exposure prophylaxis (PrEP) exacerbates HIV disparities for young men who have sex with men of color (YMSM). We explored resilience, healthcare experiences, stigma, and impact of coronavirus disease 2019 (COVID-19) on PrEP care needs among YMSM of color through virtual in-depth interviews. Analyses used adapted grounded theory/constant comparison. Regarding healthcare-based stigma, participants enacted multilevel resilience which was critical to their care retention during COVID-19 (Themes 1 and 2). Some participants noted that remote care could minimize healthcare stigma and promote retention in care and/or on PrEP (Theme 3). Participants were interested in long-acting injectable (LAI) PrEP but expressed concerns about cost, effectiveness, and side effects (Theme 4). Community-based venues like pharmacies were preferred spaces for getting LAI PrEP injections (Theme 4). Although expansion of telehealth that helped mitigate care retention challenges during COVID-19 was temporary, continued telehealth use may reduce stigmatization and promote long-term retention and PrEP persistence.
基于种族、性取向、性别认同和/或使用暴露前预防（PrEP）而产生的污名化现象，加剧了有色人种的男男性行为者（YMSM）中的艾滋病毒差异。我们通过虚拟深入访谈，探讨了有色人种 YMSM 中的韧性、医疗保健体验、污名化以及 2019 年冠状病毒病（COVID-19）对 PrEP 护理需求的影响。分析采用了适应性扎根理论/恒比法。关于基于医疗保健的污名化，参与者表现出多层次的韧性，这对他们在 COVID-19 期间保持护理至关重要（主题 1 和 2）。一些参与者指出，远程护理可以最大程度地减少医疗保健污名化，并促进保持护理和/或继续使用 PrEP（主题 3）。参与者对长效注射型 PrEP（LAI PrEP）感兴趣，但对成本、效果和副作用表示担忧（主题 4）。像药店这样的社区场所是获得 LAI PrEP 注射的首选场所（主题 4）。虽然扩大远程医疗有助于缓解 COVID-19 期间的护理保留挑战，但持续使用远程医疗可能会减少污名化，并促进长期保留和 PrEP 的持续使用。
