Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, 615 E Charles Young Drive S, Los Angeles, CA, 90095, USA.
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
AIDS Behav. 2024 May;28(5):1522-1530. doi: 10.1007/s10461-023-04178-x. Epub 2023 Oct 4.
There are limited quantitative studies describing the association between meth use in the context of male-male sexual partnerships and PrEP care engagement. We assessed the longitudinal relationship between individual and partnership level meth use with inconsistent PrEP engagement among young gay, bisexual and other men who have sex with men (GBMSM) in Los Angeles. The primary exposure was meth use at the partnership level with a ternary variable (neither partner nor participant used meth, either used meth, or both used meth). Generalized estimating equations were used to assess odds of inconsistent PrEP engagement at different levels of partner-participant meth use, adjusting for age at visit, number of recent male partners and partner intimacy. Among inconsistent PrEP engagement, 61% (n = 84, vs. 79.5%, n = 346 continuous) reported that neither they nor their partner used meth, 22% (n = 31, vs. 18%, n = 56) reported that either partner or participant used meth and 17% (n = 24, vs. 8%, n = 33) reported that both partner and participant used meth (P < 0.01). There were increased odds of inconsistent PrEP engagement when both partner and participant reported meth use (aOR: 3.82; 95%CI: 1.83-7.99) and when either partner or participant reported meth use (aOR: 2.46; 95%CI: 1.28-4.75). Meth use plays an important role in consistent PrEP engagement among GBMSM in mSTUDY. PrEP users who use meth with partners may benefit from integrated interventions addressing both meth use and PrEP engagement.
目前，关于男男性行为者性伴侣关系中使用冰毒与 PrEP 护理参与度之间的关联，仅有少量定量研究进行了描述。本研究评估了洛杉矶地区男同性恋、双性恋和其他男男性行为者（MSM）中，个体和伴侣层面冰毒使用与 PrEP 参与不一致之间的纵向关系。主要暴露因素为伴侣层面的冰毒使用，其变量为三分类变量（即无伴侣或参与者使用冰毒、有一方使用冰毒或双方均使用冰毒）。采用广义估计方程评估不同程度的伴侣-参与者冰毒使用与 PrEP 参与不一致的比值比，调整了就诊时年龄、最近男性性伴侣数量和伴侣亲密程度。在 PrEP 参与不一致的参与者中，61%（n=84，vs. 79.5%，n=346 连续）报告称他们及其伴侣均未使用冰毒，22%（n=31，vs. 18%，n=56）报告称一方或双方使用冰毒，17%（n=24，vs. 8%，n=33）报告称双方均使用冰毒（P<0.01）。当双方均报告使用冰毒（调整比值比：3.82；95%置信区间：1.83-7.99）和一方或双方报告使用冰毒（调整比值比：2.46；95%置信区间：1.28-4.75）时，PrEP 参与不一致的可能性更高。在 mSTUDY 中，冰毒使用对 MSM 持续使用 PrEP 有重要影响。与伴侣共同使用冰毒的 PrEP 用户可能需要接受综合性干预，同时解决冰毒使用和 PrEP 参与问题。
