撒哈拉以南非洲地区与男性发生性行为的男男性行为者和跨性别女性对 I-PrEP 的兴趣和参与临床试验的意愿:HPTN 075 的定量和定性研究结果。
Interest in I-PrEP and Willingness to Participate in Clinical Trials Among Men and Transfeminine Persons Who have Sex with Men in Sub-Saharan Africa: Quantitative and Qualitative Findings from HPTN 075.
机构信息
HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
Community Health and Social Sciences Department, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, USA.
出版信息
AIDS Behav. 2024 Jul;28(7):2361-2377. doi: 10.1007/s10461-024-04334-x. Epub 2024 May 18.
This study explored interest in injectable PrEP (I-PrEP) and willingness to participate in clinical trials testing new biomedical HIV prevention strategies among men and transfeminine persons who have sex with men (MSM & TGP), using data collected in the HIV Prevention Trials Network (HPTN) 075 study, which took place at sites in Kenya, Malawi, and South Africa. Data result from a survey among 267 18-44 years old HIV negative participants, complemented with semi-structured interviews with 80 purposively recruited persons. Correlations coefficients were calculated to identify demographic and psychosocial factors associated with interest in I-PrEP. Qualitative interviews were analyzed using concept-driven and subsequent data-driven coding. Most surveyed participants expressed an interest in I-PrEP. Quantitatively, only being interested in other HIV prevention measures was associated with interest in I-PrEP. Qualitatively, most participants preferred I-PrEP to O-PrEP and remained interested in I-PrEP despite barriers such as the somewhat invasive nature of the procedure and potential side effects of I-PrEP. Interest in I-PrEP was driven by the possibility of avoiding sexual or HIV stigma. Access to healthcare and altruism-such as assisting in the development of new HIV prevention methods-positively impacted willingness to participate in clinical trials. With I-PrEP favored by most participants, it is potentially a critical tool to prevent HIV infection among MSM & TGP in sub-Saharan Africa, with the mitigation of stigma as a major advance. Recruitment of MSM & TGP in biobehavioral clinical trials seems feasible, with altruistic reasons and receiving I-PrEP and free medical care as major motivators.
这项研究探讨了男男性行为者和跨性别女性(MSM&TGP)对注射用 PrEP(I-PrEP)的兴趣和参与测试新的生物医学 HIV 预防策略的临床试验的意愿,研究数据来自于 HIV 预防试验网络(HPTN)075 研究,该研究在肯尼亚、马拉维和南非的多个地点进行。研究数据来自于对 267 名年龄在 18-44 岁之间的 HIV 阴性参与者进行的一项调查,同时对 80 名有针对性招募的参与者进行了半结构化访谈。通过计算相关系数,确定了与对 I-PrEP 的兴趣相关的人口统计学和社会心理因素。使用概念驱动和随后的数据驱动编码对定性访谈进行了分析。大多数接受调查的参与者都对 I-PrEP 感兴趣。定量分析仅表明对其他 HIV 预防措施感兴趣与对 I-PrEP 的兴趣有关。定性分析表明,大多数参与者更喜欢 I-PrEP 而不是 O-PrEP,尽管存在一些障碍,如程序的侵入性和 I-PrEP 的潜在副作用,但他们仍然对 I-PrEP 感兴趣。对 I-PrEP 的兴趣源于避免性或 HIV 污名的可能性。获得医疗保健和利他主义——例如,协助开发新的 HIV 预防方法——积极影响了参与临床试验的意愿。由于大多数参与者都倾向于 I-PrEP,因此它可能是撒哈拉以南非洲地区 MSM&TGP 预防 HIV 感染的关键工具,减少污名是一个主要的进步。招募 MSM&TGP 参加生物行为学临床试验似乎是可行的,利他主义的原因和接受 I-PrEP 和免费医疗是主要的动机。