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南非一项HIV预防试验参与者的HIV风险认知、信任与暴露前预防依从性:一项定性纵向研究

HIV risk perception, trust and PrEP adherence among participants in an HIV prevention trial: a qualitative longitudinal study, South Africa.

作者信息

Chimukuche Rujeko Samanthia, Shandu Londiwe, Zulu Silindile, Khanyile Phindile, Singh Nishanta, Gaffoor Zakir, Kawuma Rachel, McCormack Sheena, Seeley Janet

机构信息

Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa

Division of Infection & Immunity, University College London, London, UK.

出版信息

BMJ Open. 2025 Apr 23;15(4):e086742. doi: 10.1136/bmjopen-2024-086742.

Abstract

INTRODUCTION

Ensuring the effectiveness of HIV prevention and treatment methods requires high levels of adherence. Studies have recognised the significance of trust in shaping HIV risk perception.

AIM

In this qualitative analysis, our aim was to explore risk perceptions and understand how individuals assess and respond to HIV risks, as well as their uptake and adherence to oral pre-exposure prophylaxis (PrEP).

SETTING

The study was based on the setting of an HIV prevention trial conducted in South Africa.

METHODS

Thirty individuals, 9% of the total clinical trial participants, enrolled in the clinical trial were purposively selected and interviewed at three time points within the trial during the follow-up phase. Data analysis was conducted using the Trust, Confidence and Cooperation framework that included constructs of trust, confidence and cooperation.

RESULTS

The findings show that the ongoing participation in the clinical trial played a significant role in influencing participants' decision to continue PrEP as HIV prevention. This decision was grounded in their trust that PrEP would effectively reduce their vulnerability to HIV and infection.

CONCLUSION

Clear and consistent health-promoting initiatives enhance participants' self-awareness of HIV risks and promote understanding (uptake) and effectiveness of HIV prevention methods.

TRIAL REGISTRATION NUMBER

NCT04066881.

摘要

引言

确保艾滋病病毒(HIV)预防和治疗方法的有效性需要高度的依从性。研究已经认识到信任在塑造HIV风险认知方面的重要性。

目的

在这项定性分析中,我们的目的是探讨风险认知,了解个体如何评估和应对HIV风险,以及他们对口服暴露前预防(PrEP)的接受和依从情况。

背景

该研究基于在南非进行的一项HIV预防试验的背景。

方法

从参与临床试验的人员中,有目的地选取了30名个体(占临床试验总参与者的9%),在试验随访阶段的三个时间点对他们进行访谈。使用包括信任、信心和合作等概念的信任、信心与合作框架进行数据分析。

结果

研究结果表明,持续参与临床试验在影响参与者继续将PrEP作为HIV预防措施的决定中发挥了重要作用。这一决定基于他们相信PrEP能有效降低他们感染HIV的易感性。

结论

明确且一致的健康促进举措可增强参与者对HIV风险的自我认知,并促进对HIV预防方法的理解(接受)和有效性。

试验注册号

NCT04066881。

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