Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
Public Health Innovation and Action, New York, NY, USA.
AIDS Care. 2024 May;36(5):692-702. doi: 10.1080/09540121.2024.2325070. Epub 2024 Mar 11.
HIV infections disproportionately impact Latinx populations in the United States, yet oral pre-exposure prophylaxis (PrEP) uptake is low. This study was a secondary gendered analysis of interviews with Latina cisgender women ( = 20) recruited from an urban safety net hospital inNew York City between August 2019 and October 2022. All women were indicated for PrEP by the provider. In-depth interviews were conducted with participants in English and Spanish and asked about social determinants of health, sexual partnerships and behaviors, and PrEP-specific enablers and barriers. Secondary thematic content analysis was conducted to identify gender-related factors influencing PrEP uptake. The following themes emerged from the data:structural factors (e.g., employment), partner-related factors, low sexual health knowledge, and resilience and empowerment. Partner-related factors were the most salient; partner infidelity served as reasons for initiating PrEP. Despite being constrained by low power in relationships, women made empowered choices to initiate PrEP and protect themselves. Findings indicated that the impact of gender inequity was an important factor in Latina women's PrEP decision making, pointing to a need to address partner-driven HIV risk, imbalance of power in relationships, and gender norms.
HIV 感染在美国不成比例地影响拉丁裔人群,但口服暴露前预防 (PrEP) 的采用率很低。这项研究是对 2019 年 8 月至 2022 年 10 月期间从纽约市一家城市社区医院招募的拉丁裔跨性别女性(=20 人)进行的二次性别分析。所有女性均由提供者指示接受 PrEP。研究人员以英语和西班牙语对参与者进行了深入访谈,询问了健康的社会决定因素、性伴侣和行为以及 PrEP 的具体促成因素和障碍。进行了二次主题内容分析,以确定影响 PrEP 采用的与性别相关的因素。数据中出现了以下主题:结构因素(例如,就业)、伴侣相关因素、性健康知识水平低以及韧性和赋权。伴侣相关因素最为突出;伴侣不忠是开始服用 PrEP 的原因。尽管在人际关系中权力有限,但女性还是做出了赋权的选择来启动 PrEP 并保护自己。研究结果表明,性别不平等的影响是拉丁裔女性 PrEP 决策的一个重要因素,这表明需要解决伴侣驱动的 HIV 风险、关系中权力失衡以及性别规范。