Santa Maria Diane, Paul Mary, Lightfoot Marguerita, Nyamathi Adeline, Quadri Yasmeen, Padhye Nikhil, Ocampo Eduardo, Babayev Roman, Ramos Melanie Watt, Malone-Thomas Sheryl L, White Margaret, Carrillo Alejandro, Jones Jennifer Torres
Diane Santa Maria, DrPH, MSN, BSN, is a Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Mary Paul, MD, is a Professor, Baylor College of Medicine, Houston, Texas, USA.
J Assoc Nurses AIDS Care. 2025;36(3):271-283. doi: 10.1097/JNC.0000000000000516. Epub 2024 Dec 24.
Adherence to preexposure prophylaxis (PrEP) is lower among high-risk populations, including youth experiencing homelessness (YEH). This study determined the feasibility of urine PrEP adherence biomarker testing and examined the barriers and facilitators to PrEP uptake and adherence among YEH. YEH were recruited from a randomized control trial conducted in a large urban setting in southern United States. Interviews ( N = 40) were conducted to identify barriers and facilitators to PrEP uptake and adherence. PrEP urine-based adherence testing feasibility was conducted among those who started on PrEP. Twenty-two participants obtained a prescription and 15 youth completed at least one adherence test. Facilitators and barriers were categorized as individual, interpersonal and community, and structural among PrEP starters and nonstarters. PrEP uptake and adherence were low for eligible YEH. Enriching the understanding of the challenges and facilitators experienced with accessing PrEP for YEH can improve engagement in HIV prevention among YEH.
包括无家可归青少年（YEH）在内的高危人群对暴露前预防（PrEP）的依从性较低。本研究确定了尿液PrEP依从性生物标志物检测的可行性，并探讨了YEH人群中PrEP使用和依从性的障碍及促进因素。YEH是从美国南部一个大城市开展的一项随机对照试验中招募的。进行了访谈（N = 40）以确定PrEP使用和依从性的障碍及促进因素。在开始使用PrEP的人群中进行了基于尿液的PrEP依从性检测可行性研究。22名参与者获得了处方，15名青少年完成了至少一次依从性检测。在开始使用PrEP者和未使用者中，促进因素和障碍被分为个人、人际和社区以及结构因素。符合条件的YEH对PrEP的使用和依从性较低。深入了解YEH在获取PrEP方面所面临的挑战和促进因素，可提高YEH人群对艾滋病毒预防的参与度。
