Department of Medicine, Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, RI.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI.
J Acquir Immune Defic Syndr. 2024 Sep 1;97(1):26-39. doi: 10.1097/QAI.0000000000003461.
BACKGROUND: Preexposure prophylaxis (PrEP) is an effective biological option for HIV prevention yet persistent disparities in PrEP uptake and retention exist among Hispanic/Latino men who have sex with men (MSM). We evaluated barriers and facilitators to PrEP care among Hispanic/Latino MSM at risk for and living with HIV. SETTING: A small urban setting in the Northeastern United States. METHODS: This was a mixed-methods, exploratory, sequential, qualitative and quantitative pilot study among Latino MSM at-risk and/or living with HIV across (1) semistructured qualitative interviews (N = 15) and (2) cross-sectional survey (N = 98). RESULTS: Participants reported a diverse range of sexual identities, HIV statuses, and PrEP statuses. Qualitative participants described feelings of isolation in both Hispanic/Latino and queer communities that made it challenging to learn about HIV prevention or PrEP from peers. Participants in the survey indicated that they would be more inclined to uptake PrEP if PrEP were offered in primary care settings (n = 61; 62.2%); there were specific LGBTQ+ affirming medical settings (n = 36; 36.7%); and/or they could meet other people who are currently on PrEP and sharing experiences online (n = 46; 46.9%) or in person (n = 38; 38.8%). Findings were organized to reflect determinants and implementation strategies that could be used to improve PrEP uptake among this population. CONCLUSIONS: This mixed-methods study identified several challenges and opportunities for increasing the reach of PrEP to Hispanic/Latino MSM. These findings should be used to inform tailored implementation strategies to promote PrEP uptake among this at-risk yet currently underserved population.
背景:暴露前预防(PrEP)是预防 HIV 的有效生物学选择,但在有感染 HIV 风险和已经感染 HIV 的西班牙裔/拉丁裔男男性行为者(MSM)中,PrEP 的使用率和保留率仍存在持续差异。我们评估了有感染 HIV 风险和已经感染 HIV 的西班牙裔/拉丁裔 MSM 接受 PrEP 护理的障碍和促进因素。
地点:美国东北部的一个小城区。
方法:这是一项混合方法、探索性、顺序、定性和定量的试点研究,涉及(1)有感染 HIV 风险和/或已经感染 HIV 的拉丁裔 MSM 的半结构式定性访谈(N=15)和(2)横断面调查(N=98)。
结果:参与者报告了各种不同的性身份、HIV 状况和 PrEP 状况。定性参与者描述了在西班牙裔/拉丁裔和酷儿社区中感到孤立无援,这使得他们很难从同龄人那里了解 HIV 预防或 PrEP。调查参与者表示,如果 PrEP 在初级保健环境中提供(n=61;62.2%);有特定的 LGBTQ+ 认可的医疗环境(n=36;36.7%);并且/或者他们可以与其他正在服用 PrEP 并在线分享经验的人(n=46;46.9%)或面对面(n=38;38.8%)联系,他们更有可能接受 PrEP。调查结果组织起来,以反映可以用来提高这一人群接受 PrEP 率的决定因素和实施策略。
结论:这项混合方法研究确定了增加西班牙裔/拉丁裔 MSM 获得 PrEP 的机会的几个挑战和机遇。这些发现应被用于为这一有感染风险但目前服务不足的人群提供有针对性的实施策略,以促进 PrEP 的使用。
Cochrane Database Syst Rev. 2008-7-16
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Health Aff (Millwood). 2020-3