Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York.
AIDS Educ Prev. 2023 Oct;35(5):406-419. doi: 10.1521/aeap.2023.35.5.406.
Since it was established that HIV-positive individuals who maintain an undetectable viral load are unable to sexually transmit HIV (U=U), treatment as prevention (TasP) has become an important biomedical HIV prevention option. Many have remained optimistic that TasP, combined with pre-exposure prophylaxis (PrEP), will help close the "viral divide" between those living with and without HIV. This qualitative interview study of 62 sexual and gender minority (SGM) individuals of mixed serostatuses explored community perspectives regarding TasP, including the meaning of undetectability and how U=U impacts understandings of serodifference. Five key themes emerged from interviews: (1) undetectable does not equal HIV-negative, (2) PrEP is more promoted than TasP, (3) TasP increases openness to serodifferent sex, (4) rejection of TasP absolutism, and (5) the importance of layering prevention strategies. These findings suggest that while TasP is helping to bridge the viral divide, serostatus distinctions remain prevalent and important to many SGM individuals.
由于已经确定病毒载量无法检测到的 HIV 阳性个体无法通过性传播 HIV（U=U），因此治疗即预防（TasP）已成为一种重要的生物医学 HIV 预防选择。许多人仍然乐观地认为，TasP 结合暴露前预防（PrEP）将有助于缩小 HIV 感染者和未感染者之间的“病毒鸿沟”。本项针对 62 名混合血清学状况的性少数群体（SGM）个体的定性访谈研究探讨了社区对 TasP 的看法，包括不可检测的含义以及 U=U 如何影响对血清差异的理解。访谈中出现了五个主要主题：（1）不可检测并不等于 HIV 阴性，（2）PrEP 的推广度高于 TasP，（3）TasP 增加了对血清差异性行为的开放性，（4）反对 TasP 绝对主义，以及（5）分层预防策略的重要性。这些发现表明，虽然 TasP 有助于缩小病毒鸿沟，但血清学差异对许多 SGM 个体仍然普遍且重要。
