School of Public Health, San Diego State University, San Diego, CA, United States of America.
RAND Corporation, Santa Monica, CA, United States of America.
AIDS Behav. 2024 Apr;28(4):1216-1226. doi: 10.1007/s10461-023-04144-7. Epub 2023 Sep 12.
Young adults experiencing homelessness (YAEH) are at elevated risk for HIV compared to their stably housed peers. Preexposure prophylaxis (PrEP) is highly effective at preventing HIV infection, yet YAEH have been largely overlooked in PrEP efforts to date despite YAEH reporting high overall interest in PrEP. We assessed individual, social, and structural variables associated with PrEP interest and use among a sample of 195 YAEH (ages 18-25) recruited from drop-in centers across Los Angeles County who met criteria for HIV risk. In the current sample, though most had heard of PrEP (81.0%), the majority were not interested in taking PrEP (68.2%) and only a minority had used/were using PrEP (11.8%). YAEH who identified as sexual and/or gender minority, reported knowing someone who had used PrEP, or recently accessed sexual health services were more likely to have used and/or reported interest in using PrEP. Those who reported more episodes of heavy drinking were less likely to report having used PrEP. Suggestions are provided for better integrating PrEP-related services into existing behavioral and health service programs for YAEH, as well as leveraging peers and fostering positive social norms to reduce PrEP-related stigma and increase interest and use of PrEP among YAEH.
与稳定住房的同龄人相比,无家可归的年轻成年人(YAEH)感染 HIV 的风险更高。暴露前预防(PrEP)在预防 HIV 感染方面非常有效,但迄今为止,YAEH 在 PrEP 工作中基本上被忽视了,尽管 YAEH 报告对 PrEP 总体兴趣很高。我们评估了与洛杉矶县各集散中心招募的 195 名 YAEH(年龄在 18-25 岁之间)的 PrEP 兴趣和使用相关的个体、社会和结构变量,这些人符合 HIV 风险标准。在当前的样本中,尽管大多数人听说过 PrEP(81.0%),但大多数人对服用 PrEP 不感兴趣(68.2%),只有少数人使用/正在使用 PrEP(11.8%)。自认为是性和/或性别少数群体的 YAEH、报告认识使用过 PrEP 的人、或最近获得性健康服务的人更有可能使用和/或报告有兴趣使用 PrEP。报告更多重度饮酒事件的人不太可能报告使用过 PrEP。为了更好地将 PrEP 相关服务纳入现有的 YAEH 行为和健康服务计划,以及利用同伴并培养积极的社会规范,以减少 PrEP 相关污名,提高 YAEH 对 PrEP 的兴趣和使用,提出了建议。