Reyes Nequiel, Lozano Alyssa, Weinstein Elliott R, Feaster Daniel J, Harkness Audrey
Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida, USA.
School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA.
AIDS Patient Care STDS. 2025 Feb;39(2):70-79. doi: 10.1089/apc.2024.0208. Epub 2025 Jan 8.
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool available in several modalities (e.g., daily oral, injectable, implants, rectal douching). The Ending the HIV Epidemic (EHE) initiative, a national initiative that began in 2019 as a partnership among the Department of Health and Human Services and other federal agencies (e.g., the Centers for Disease Control and Prevention, National Institute of Health), seeks to increase PrEP engagement for groups experiencing HIV inequities, including Latino sexual minority men (LSMM). Given the limited research on PrEP modality preferences among LSMM, this study aimed to explore and characterize these preferences. LSMM ( = 214) not using PrEP and living in South Florida participated in the DÍMELO study, which examined PrEP engagement among LSMM in South Florida. Authors employed latent class analysis (LCA) to identify groups of LSMM based on their PrEP modality preferences and examined predictors of class membership. LCA results led to a three-class solution with participants who were: (1) reluctant to use most PrEP modalities (30.5%), (2) PrEP willing, with constraints (36.0%), and (3) enthusiastically accepting of all PrEP modalities (33.5%). LSMM in the reluctant class (Class 1) showed minimal interest in most PrEP modalities. The constrained class (Class 2) displayed interest in daily oral, on-demand, and quarterly injectable PrEP while the enthusiastic class (Class 3) demonstrated high interest in all modalities except rectal douching. Key predictors of PrEP modality preferences were altruism, community normalization of PrEP, and migration history. Understanding LSMM's PrEP modality preferences can enhance the reach of PrEP to LSMM, a group the EHE initiative prioritizes. The current findings suggest the need to tailor PrEP outreach efforts to promote various PrEP modalities based on LSMM's preferences.
暴露前预防（PrEP）是一种有效的艾滋病毒预防工具，有多种使用方式（如每日口服、注射、植入、直肠冲洗）。“终结艾滋病毒流行”（EHE）倡议是一项于2019年启动的全国性倡议，由卫生与公众服务部及其他联邦机构（如疾病控制与预防中心、国立卫生研究院）合作开展，旨在提高艾滋病毒防治不平等群体（包括拉丁裔性少数男性[LSMM]）对PrEP的接受度。鉴于针对LSMM对PrEP使用方式偏好的研究有限，本研究旨在探索并描述这些偏好。214名未使用PrEP且居住在南佛罗里达的LSMM参与了DÍMELO研究，该研究考察了南佛罗里达LSMM对PrEP的接受情况。作者采用潜在类别分析（LCA）根据LSMM对PrEP使用方式的偏好确定其类别，并研究类别归属的预测因素。LCA结果得出一个三类解决方案，参与者分别为：（1）不愿使用大多数PrEP方式的人（30.5%），（2）愿意使用PrEP但有顾虑的人（36.0%），以及（3）积极接受所有PrEP方式的人（33.5%）。不愿使用类（第1类）的LSMM对大多数PrEP方式兴趣不大。有顾虑类（第2类）对每日口服、按需服用和每季度注射的PrEP表现出兴趣，而积极接受类（第3类）对除直肠冲洗外的所有方式都表现出高度兴趣。PrEP使用方式偏好的关键预测因素是利他主义、PrEP在社区的常态化以及移民史。了解LSMM对PrEP使用方式的偏好可以扩大PrEP对LSMM的覆盖范围，而LSMM是EHE倡议优先关注的群体。目前的研究结果表明，有必要根据LSMM的偏好调整PrEP推广工作，以促进各种PrEP方式的使用。
