Cox Laura Ashleigh, Martin Catherine E, Nongena Pelisa, Mvelase Sanele, Kutywayo Alison, Mullick Saiqa
Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
J Adolesc Health. 2023 Dec;73(6S):S92-S100. doi: 10.1016/j.jadohealth.2023.08.017.
PURPOSE: This study describes a cohort of men seeking oral pre-exposure prophylaxis (PrEP) services and explores their patterns of PrEP use within an implementation project seeking to integrate PrEP provision within sexual and reproductive health services in public health clinics in South Africa. METHODS: Routine program and survey data from 364 males initiated on oral PrEP between July 2020 and May 2022 were analyzed. PrEP use was examined, including time to first discontinuation and restart patterns. Factors associated with early PrEP discontinuation and PrEP restart were analyzed. RESULTS: Despite primarily focusing on access for adolescent girls and young women, PrEP services reached males with HIV prevention needs. PrEP use for ≤1 month (early discontinuation) was high at 58%; however, 18% restarted on PrEP, with 4% restarting repeatedly. Having depression symptoms was associated with early PrEP discontinuation (adjusted odds ratio [AOR]: 1.71, 95% CI [confidence interval]: 1.06-2.78). Those ≥25 years were less likely to discontinue early, as were those with a partner treated for a sexually transmitted infection in the preceding three months (AOR: 0.33, 95% CI: 0.13-0.84) and those who had been circumcised (AOR: 0.59, 95% CI: 0.36-0.96). Those 18-20 years old were less likely to restart PrEP than those ≥25 years (AOR: 0.43, 95% CI: 0.19-0.97), as were those whose partner's HIV status was unknown (AOR: 0.33, 95% CI: 0.12-0.88). DISCUSSION: This study identified interest and uptake of oral PrEP among an underrepresented population of predominantly heterosexual males seeking sexual and reproductive health services. It found high rates of early PrEP discontinuation, with a subset returning to restart PrEP. Further research is needed to determine whether these periods of PrEP use are associated with periods of HIV risk.
目的：本研究描述了一组寻求口服暴露前预防（PrEP）服务的男性群体，并在一个实施项目中探讨了他们使用PrEP的模式，该项目旨在将PrEP服务纳入南非公共卫生诊所的性与生殖健康服务中。 方法：分析了2020年7月至2022年5月期间开始接受口服PrEP的364名男性的常规项目和调查数据。对PrEP的使用情况进行了检查，包括首次停药时间和重新开始用药的模式。分析了与早期停用PrEP和重新开始使用PrEP相关的因素。 结果：尽管主要关注青少年女孩和年轻女性的获取情况，但PrEP服务仍覆盖到了有预防艾滋病需求的男性。PrEP使用时间≤1个月（早期停药）的比例很高，达58%；然而，18%的人重新开始使用PrEP，其中4%的人反复重新开始用药。有抑郁症状与早期停用PrEP相关（调整后的优势比[AOR]：1.71，95%置信区间[CI]：1.06 - 2.78）。年龄≥25岁的人早期停药的可能性较小，前三个月有性传播感染治疗史的伴侣的人（AOR：0.33，95%CI：0.13 - 0.84）以及接受过包皮环切术的人（AOR：0.59，95%CI：0.36 - 0.96）也是如此。18 - 20岁的人比≥25岁的人重新开始使用PrEP的可能性更小（AOR：0.43，95%CI：0.19 - 0.97），伴侣的艾滋病毒感染状况未知的人也是如此（AOR：0.33，95%CI：0.12 - 0.88）。 讨论：本研究确定了在寻求性与生殖健康服务的以异性恋为主的男性这一代表性不足的人群中，对口服PrEP存在兴趣并有人使用。研究发现早期停用PrEP的比例很高，有一部分人会重新开始使用PrEP。需要进一步研究来确定这些PrEP使用期是否与艾滋病风险期相关。
J Int AIDS Soc. 2025-2
EClinicalMedicine. 2024-5-17
Zotero 插件