Betty Irene Moore School of Nursing, University of California, Davis, Davis, CA, USA.
Clinical and Translational Science Center Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Davis, CA, USA.
Issues Ment Health Nurs. 2024 Sep;45(9):937-947. doi: 10.1080/01612840.2024.2366324. Epub 2024 Aug 22.
HIV post-exposure prophylaxis (PEP) can reduce the risk of acquiring HIV infection following sexual assault. However, only about half of people offered HIV PEP will initiate the medication. Factors associated with patient readiness for HIV PEP following sexual assault have been attributed to structural and clinical barriers. This study utilized the Theory of Reasoned Action and Planned Behavior to better understand how personal factors, cognitive factors, mental health, barriers and facilitators that could influence a patient's decision to start HIV PEP post sexual assault. A web-based cross sectional survey was conducted from October 2017 to January 2020 and a total of 228 responses were included from participants that had experienced sexual assault in the previous 3 months. Using linear regression modeling fear of HIV, post-traumatic stress symptoms, validating social responses to disclosure, and having someone else pay for HIV PEP were all associated with feeling better prepared for HIV PEP decision making. Results indicate that structural, social, and individual factors impact patient decision making. These findings highlight opportunities for health systems and providers to improve HIV education and the importance of initiating HIV PEP following sexual assault.
HIV 暴露后预防 (PEP) 可以降低性侵犯后感染 HIV 的风险。然而，只有大约一半接受 HIV PEP 建议的人会开始服用药物。与性侵犯后 HIV PEP 患者准备情况相关的因素归因于结构性和临床障碍。本研究利用理性行为理论和计划行为理论来更好地理解个人因素、认知因素、心理健康、障碍和促进因素如何影响患者开始 HIV PEP 的决定。这项研究从 2017 年 10 月至 2020 年 1 月进行了一项基于网络的横断面调查，共纳入了 228 名在过去 3 个月内遭受性侵犯的参与者的回复。使用线性回归模型，对 HIV 的恐惧、创伤后应激症状、对披露的有效社会反应以及他人支付 HIV PEP 的意愿都与对 HIV PEP 决策更有准备的感觉有关。结果表明，结构性、社会性和个体因素会影响患者的决策。这些发现突出了卫生系统和提供者改善 HIV 教育以及在性侵犯后启动 HIV PEP 的重要性。
