From the Department of Behavioral and Social Sciences, Brown University School of Public Health.
Division of Infectious Diseases, The Miriam Hospital.
Sex Transm Dis. 2024 Mar 1;51(3):162-170. doi: 10.1097/OLQ.0000000000001912. Epub 2023 Dec 28.
People experiencing incarceration are disproportionately impacted by HIV and are potential candidates for HIV preexposure prophylaxis (PrEP). We explored factors associated with PrEP interest and PrEP uptake and described barriers to PrEP uptake among incarcerated men in a state correctional system.
From September 2019 to July 2022, incarcerated men at the Rhode Island Department of Corrections were screened for PrEP eligibility and referred to a PrEP initiation study. We used bivariate analyses and multivariable logistic regression models to explore factors associated with PrEP interest and uptake in the screening sample.
Of the men screened and determined to be eligible for PrEP, approximately half (50%) were interested in taking PrEP. Individuals identifying as men who have sex with men (adjusted odds ratio, 4.46; 95% confidence interval, 1.86-11.4) and having multiple female sex partners (adjusted odds ratio, 2.98; 95% confidence interval, 1.47-6.27) were more likely to express interest in PrEP (interested/not interested) than those not reporting these behavioral factors. Preexposure prophylaxis uptake (yes/no) was 38%. Lack of PrEP interest, low self-perceived risk of HIV acquisition, and unpredictable lengths of incarceration were the most frequently encountered barriers to PrEP uptake.
Men reporting sexual transmission behaviors were more interested in PrEP and had higher uptake than other men. Preexposure prophylaxis interest and HIV risk factors were both moderately high, which suggests that men experiencing incarceration should be screened for and offered PrEP as part of standard clinical care. Study findings have important implications for research and practice to adapt PrEP care to correctional systems.
被监禁的人感染 HIV 的风险不成比例地高，是 HIV 暴露前预防 (PrEP) 的潜在候选人。我们探讨了与 PrEP 兴趣和 PrEP 使用率相关的因素，并描述了在一个州立惩教系统中被监禁的男性中接受 PrEP 的障碍。
从 2019 年 9 月至 2022 年 7 月，罗得岛惩教署的被监禁男性接受了 PrEP 资格筛查，并被转介到 PrEP 启动研究中。我们使用双变量分析和多变量逻辑回归模型来探讨筛查样本中与 PrEP 兴趣和使用率相关的因素。
在所筛选并确定有资格接受 PrEP 的男性中，约有一半（50%）表示有兴趣服用 PrEP。被确定为男男性行为者（调整后的优势比，4.46；95%置信区间，1.86-11.4）和有多个女性性伴侣（调整后的优势比，2.98；95%置信区间，1.47-6.27）的个体比没有报告这些行为因素的个体更有可能对 PrEP 感兴趣（感兴趣/不感兴趣）。PrEP 使用率（是/否）为 38%。缺乏 PrEP 兴趣、低自我感知的 HIV 感染风险和不可预测的监禁时间是接受 PrEP 的最大障碍。
报告性传播行为的男性对 PrEP 更感兴趣，接受率也更高。PrEP 兴趣和 HIV 风险因素都处于中等偏高水平，这表明被监禁的男性应该接受筛查，并将 PrEP 作为标准临床护理的一部分提供。研究结果对研究和实践具有重要意义，可以使 PrEP 护理适应惩教系统。
