探索影响津巴布韦布拉瓦约男男性行为者口服暴露前预防措施使用率的障碍和促进因素:主要利益相关者的观点。

Exploring Barriers and Facilitators That Influence Uptake of Oral Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Bulawayo, Zimbabwe: Key Stakeholder's Perspectives.

机构信息

Department of Environmental Health, Faculty of Environmental Science, National University of Science and Technology, Bulawayo, Zimbabwe.

出版信息

Am J Mens Health. 2024 Jan-Feb;18(1):15579883231223377. doi: 10.1177/15579883231223377.

Abstract

The world has been on the path to ending HIV and AIDS as a global threat by 2030; despite these efforts, the rate of new HIV infections among men who have sex with men remains very high. This study sought to explore the perceptions of key stakeholders on the potential barriers and facilitators of pre-exposure prophylaxis use among this key population. An exploratory, descriptive (through interviews) qualitative study was conducted on 10 key informants who were purposively selected and snowballed based on their knowledge and experience toward pre-exposure prophylaxis programming among men who have sex with men. The interviews were recorded, transcribed verbatim, coded, and thematically analyzed on MAXQDA. Stated barriers were stigma, lack of information, wrong messaging around pre-exposure prophylaxis, hearing negative things about the pills, the burden of taking pills daily, negative attitudes from health care providers, non-friendly health care facilities, pre-exposure prophylaxis not being affordable, and lack of flexibility and privacy from public hospitals. Identified facilitators were correct messaging on pre-exposure prophylaxis, long-lasting injectable pre-exposure prophylaxis, improved packaging, de-stigmatization, more friendly facilities, differentiated service approach, community groups, engagement, and partnership. To address these barriers and leverage the facilitators, it is imperative to have accessible, affordable services, non-judgmental health care providers, and peer support networks to empower men who have sex with men to make informed decisions regarding their sexual and reproductive health. Continued efforts to remove barriers and promote facilitators are crucial for maximizing the potential of pre-exposure prophylaxis as an effective HIV prevention tool among this population.

摘要

全球一直在努力,以期在 2030 年前消除艾滋病毒和艾滋病这一全球威胁;尽管作出了这些努力,但男男性行为者中的新感染艾滋病毒率仍然很高。本研究旨在探讨关键利益攸关方对男男性行为者中使用暴露前预防措施的潜在障碍和促进因素的看法。在对 10 名关键知情人进行了探索性、描述性(通过访谈)的定性研究,这些知情人是根据他们在男男性行为者中开展暴露前预防规划方面的知识和经验有目的地选择和滚雪球式选择的。访谈进行了录音、逐字转录、编码,并在 MAXQDA 上进行了主题分析。存在的障碍是污名化、信息缺乏、围绕暴露前预防措施的错误信息传递、听到有关药丸的负面信息、每天服用药丸的负担、医疗保健提供者的负面态度、不友好的医疗设施、暴露前预防措施负担不起以及公共医院缺乏灵活性和隐私。确定的促进因素是暴露前预防措施的正确信息传递、长效注射型暴露前预防措施、改进的包装、去污名化、更友好的设施、差异化的服务方法、社区团体、参与和伙伴关系。为了解决这些障碍并利用促进因素,必须提供可及、负担得起的服务、不评判的医疗保健提供者以及同伴支持网络,以使男男性行为者能够就其性健康和生殖健康做出明智的决定。继续努力消除障碍和促进因素对于最大限度地发挥暴露前预防措施作为这一人群中有效艾滋病毒预防工具的潜力至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fb7/10771743/d1b43139017b/10.1177_15579883231223377-fig1.jpg

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