Department of Infectious Diseases, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands.
Sci Rep. 2023 Sep 27;13(1):16168. doi: 10.1038/s41598-023-42762-2.
Biomedical HIV-prevention strategies (BmPS) among men who have sex with men (MSM), such as pre-exposure prophylaxis (PrEP) and viral load sorting (VLS), are essential but relatively new and their uptake gradual. Using an extension of the causal attitude network approach, we investigated which beliefs are related to uptake of PrEP and VLS at each time-point. We included 632 HIV-negative MSM from the Amsterdam Cohort Studies from four data-waves between 2017 and 2019. We estimated weighted, undirected networks for each time-point, where we included pairwise interactions of PrEP and VLS uptake and related beliefs. PrEP use increased from 10 to 31% (p < 0.001), while VLS was reported by 7-10% at each time-point. Uptake of both BmPS was directly related to the perceived positive impact of the strategy on one's quality of sex life and perceived supportive social norms. Overall network structure differed between time points, specifically in regard to PrEP. At earlier time points, perceptions of efficacy and affordability played an important role for PrEP uptake, while more recently social and health-related concerns became increasingly important.The network structure differed across data-waves, suggesting specific time changes in uptake motives. These findings may be used in communication to increase prevention uptake.
男男性行为者（MSM）中的生物医学 HIV 预防策略（BmPS），如暴露前预防（PrEP）和病毒载量分类（VLS），是必不可少的，但相对较新，其采用率也逐渐提高。我们使用因果态度网络方法的扩展，研究了在每个时间点与 PrEP 和 VLS 采用相关的信念。我们纳入了 2017 年至 2019 年期间来自阿姆斯特丹队列研究的 632 名 HIV 阴性 MSM。我们为每个时间点估计了加权、无向网络，其中包括 PrEP 和 VLS 采用和相关信念的两两交互。PrEP 的使用从 10%增加到 31%（p<0.001），而 VLS 在每个时间点的报告率为 7-10%。两种 BmPS 的采用都与策略对性行为质量的感知积极影响以及感知到的支持性社会规范直接相关。总体网络结构在不同时间点存在差异，特别是在 PrEP 方面。在早期时间点，对疗效和负担能力的看法对 PrEP 的采用起着重要作用，而最近，社会和健康相关的担忧变得越来越重要。网络结构在数据波之间存在差异，表明采用动机存在特定的时间变化。这些发现可用于提高预防措施的采用率。
