Irie Whitney C, Mahone Anais, Nakka Raja, Ghebremichael Musie
Boston College School of Social Work, Chestnut Hill, MA 02467, USA.
The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
Trop Med Infect Dis. 2023 Sep 7;8(9):436. doi: 10.3390/tropicalmed8090436.
Preexposure prophylaxis (PrEP) for HIV prevention uptake remains low among Black cisgender women in the United States, despite their disproportionate HIV burden. This study aimed to examine factors associated with Black women's comfort discussing PrEP with healthcare providers and its link to their interest in PrEP use. A cross-sectional survey was conducted with a national sample of 315 Black cisgender women. Descriptive statistics and logistic regression models were utilized for data analysis. The results showed that 79% of Black women felt comfortable discussing PrEP with their healthcare provider. Age, recent healthcare provider visit, interest in PrEP, and positive social norms were associated with increased odds of comfort in discussing PrEP, while anticipated PrEP disapproval and stigma were associated with decreased odds. Older age was related to greater comfort, potentially due to increased familiarity and self-efficacy in discussing sexual health. Recent healthcare utilization indicated positive provider relationships, facilitating discussions about sexual health. Anticipating support from social networks positively influenced comfort levels. Conversely, PrEP-related stigma and anticipated disapproval were barriers to comfort. These findings highlight the importance of provider-patient communication and social support in facilitating PrEP engagement among Black cisgender women. Interventions should consider age-appropriate strategies and address structural and provider biases to improve PrEP discussions and promote HIV prevention.
在美国,尽管黑人顺性别女性承受着不成比例的艾滋病病毒负担,但用于预防艾滋病病毒的暴露前预防(PrEP)的使用率仍然很低。本研究旨在探讨与黑人女性与医疗服务提供者讨论PrEP时的舒适度相关的因素,以及这与她们使用PrEP的兴趣之间的联系。对315名黑人顺性别女性的全国样本进行了横断面调查。描述性统计和逻辑回归模型用于数据分析。结果显示,79%的黑人女性在与医疗服务提供者讨论PrEP时感到自在。年龄、最近看医疗服务提供者的经历、对PrEP的兴趣以及积极的社会规范与讨论PrEP时舒适度增加的几率相关,而预期的PrEP不赞同和污名化则与几率降低相关。年龄较大与更高的舒适度相关,这可能是由于在讨论性健康方面的熟悉度和自我效能感增加。最近的医疗服务利用表明与医疗服务提供者关系良好,有利于关于性健康的讨论。预期来自社交网络的支持对舒适度有积极影响。相反,与PrEP相关的污名化和预期的不赞同是舒适度的障碍。这些发现凸显了医患沟通和社会支持在促进黑人顺性别女性参与PrEP方面的重要性。干预措施应考虑适合年龄的策略,并解决结构性和医疗服务提供者的偏见,以改善关于PrEP的讨论并促进艾滋病病毒预防。