Dias Rita, Rocha Miguel, Veríssimo Luís, Ferreira Fernando, Novais Maria João, Severo Milton, Fraga Sílvia, Meireles Paula
EPIUnit ITR, Instituto de Saúde Pública da Universidade do Porto, Universidade do Porto, Rua das Taipas, n° 135, Porto, 4050-600, Portugal.
GAT - Grupo de Ativistas em Tratamentos, Lisboa, Portugal.
AIDS Behav. 2025 Apr 17. doi: 10.1007/s10461-025-04693-z.
This study aims to examine how HIV prevention tools were used and how they clustered together among men who have sex with men (MSM) testing at a community-based sexual health center in Lisbon, Portugal, from 2014 to 2021. We used data from 16,780 visits from adult cisgender MSM and had an HIV-negative test result at baseline in the Lisbon Cohort of MSM-an open, prospective cohort study conducted at CheckpointLX, a community-based sexual health center tailored to MSM, from 2014 to 2021. A longitudinal clustering approach was used to identify clusters of HIV prevention (cluster package for R). Six clusters of HIV prevention were identified: condom use (9,109 visits); low or no condom use, low PrEP (preexposure prophylaxis) use (6,258 visits); anal sex abstinence (746 visits); PEP (postexposure prophylaxis) and condom use (305 visits); PEP use (186 visits); and PrEP and condom use (176 visits). Most participants were aged 24 to 34 years old, were born in Portugal, had high education, and self-identified as gay. PrEP and PEP uptake were more associated with being born in Brazil, while low prevention adherence was less associated with high education. Condom use was the most frequently reported prevention strategy, followed by the low or no condom use, low PrEP use cluster. However, participants with higher odds of reporting HIV risk behaviors were the ones allocated to clusters with reports of higher frequency of prevention tools utilization.
本研究旨在探讨2014年至2021年期间，在葡萄牙里斯本一家社区性健康中心接受检测的男男性行为者（MSM）中，艾滋病毒预防工具的使用情况以及它们是如何聚集在一起的。我们使用了来自16780名成年顺性别男男性行为者就诊的数据，这些数据来自里斯本男男性行为者队列研究的基线艾滋病毒阴性检测结果，这是一项在CheckpointLX开展的开放、前瞻性队列研究，CheckpointLX是一家专门为男男性行为者服务的社区性健康中心，研究时间为2014年至2021年。采用纵向聚类方法来识别艾滋病毒预防聚类（R语言的cluster包）。识别出了六个艾滋病毒预防聚类：使用避孕套（9109次就诊）；低避孕套使用或不使用避孕套、低暴露前预防（PrEP）使用率（6258次就诊）；肛交禁欲（746次就诊）；暴露后预防（PEP）和避孕套使用（305次就诊）；使用PEP（186次就诊）；以及PrEP和避孕套使用（176次就诊）。大多数参与者年龄在24至34岁之间，出生在葡萄牙，受过高等教育，自我认同为同性恋。PrEP和PEP的接受率与出生在巴西的关联性更强，而低预防依从性与高等教育的关联性较小。避孕套使用是最常报告的预防策略，其次是低避孕套使用或不使用避孕套、低PrEP使用率聚类。然而，报告艾滋病毒风险行为几率较高的参与者被分配到了报告预防工具使用频率较高的聚类中。
