Magno Laio, Leite Beo Oliveira, Grangeiro Alexandre, Dezanet Lorenza, Soares Fabiane, Dourado Inês
Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brazil.
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil.
J Int AIDS Soc. 2025 Jul;28 Suppl 2(Suppl 2):e26479. doi: 10.1002/jia2.26479.
INTRODUCTION: New pre-exposure prophylaxis (PrEP) options, including event-driven and long-acting injectable, may enhance HIV prevention strategies among adolescents and youth. This study examined awareness and intention to use event-driven and long-acting injectable PrEP, along with associated factors, among adolescent and young men who have sex with men and transgender women. METHODS: A cross-sectional study was conducted between December 2020 and February 2022 among men who have sex with men and young transgender women aged 15-20 years, who participated in a daily oral PrEP cohort study in Salvador and São Paulo, Brazil. Binomial logistic regression models analysed factors associated with the intention to use event-driven and long-acting injectable PrEP. RESULTS: A total of 1221 participants were enrolled in the cohort at the time of this analysis, with 597 responding to the survey. Awareness of event-driven and long-acting injectable PrEP was reported by 15.3% and 18.0% of participants, respectively. Intention to use event-driven PrEP was reported by 56.4% of participants, while 81.5% expressed intention to use long-acting injectable PrEP. Participants with lower and moderate adherence to daily oral PrEP were more likely to intend to use event-driven PrEP (OR = 1.79; 95% CI: 1.04-3.08), whereas those who reported always or often using condoms in insertive anal sex with steady or casual partners were less likely to intend to use event-driven PrEP (OR = 0.37; 95% CI: 0.15-0.90). For long-acting injectable PrEP, participants with middle (OR = 1.93; 95% CI: 1.05-3.53) or low socio-economic status (OR = 3.13; 95% CI: 1.30-7.51) and those reporting three or more casual partners in the past 3 months (OR = 2.25; 95% CI: 1.30-3.89) were more likely to intend to use long-acting injectable PrEP. Conversely, participants who had never used daily oral PrEP were less likely to intend to use long-acting injectable PrEP (OR = 0.31; 95% CI: 0.11-0.92). CONCLUSIONS: Adolescents and young people in Brazil demonstrated a stronger preference for long-acting injectable over event-driven PrEP, with sexual behaviour patterns significantly influencing choices. Expanding prevention options may enhance PrEP uptake and adherence, improving HIV prevention strategies among adolescents and young adults.
引言：新的暴露前预防（PrEP）方案，包括事件驱动型和长效注射型，可能会增强青少年和青年群体中的艾滋病预防策略。本研究调查了男男性行为者和变性女性中对事件驱动型和长效注射型PrEP的知晓情况、使用意愿以及相关因素。 方法：2020年12月至2022年2月期间，在巴西萨尔瓦多和圣保罗参与每日口服PrEP队列研究的15至20岁男男性行为者和年轻变性女性中开展了一项横断面研究。采用二项逻辑回归模型分析与使用事件驱动型和长效注射型PrEP意愿相关的因素。 结果：在本次分析时，共有1221名参与者纳入该队列，其中597人回应了调查。分别有15.3%和18.0%的参与者知晓事件驱动型和长效注射型PrEP。56.4%的参与者表示有使用事件驱动型PrEP的意愿，而81.5%的参与者表示有使用长效注射型PrEP的意愿。对每日口服PrEP依从性较低和中等的参与者更有可能打算使用事件驱动型PrEP（比值比[OR]=1.79；95%置信区间[CI]：1.04 - 3.08），而那些报告在与固定或临时伴侣进行插入式肛交时总是或经常使用避孕套的参与者打算使用事件驱动型PrEP的可能性较小（OR = 0.37；95% CI：0.15 - 0.90）。对于长效注射型PrEP，社会经济地位中等（OR = 1.93；95% CI：1.05 - 3.53）或较低（OR = 3.13；95% CI：1.30 - 7.51）以及在过去3个月内报告有三个或更多临时伴侣的参与者更有可能打算使用长效注射型PrEP。相反，从未使用过每日口服PrEP的参与者打算使用长效注射型PrEP的可能性较小（OR = 0.31；95% CI：0.11 - 0.92）。 结论：巴西的青少年和年轻人对长效注射型PrEP的偏好高于事件驱动型PrEP，性行为模式对选择有显著影响。扩大预防方案可能会提高PrEP的接受度和依从性，改善青少年和青年成年人中的艾滋病预防策略。
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