Gatanaga Ohshue S, Lanza Dalila Victoria, Pitts Robert A, Braithwaite Ronald S, Lim Sahnah
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, United States of America.
Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America.
PLoS One. 2025 Jul 11;20(7):e0327677. doi: 10.1371/journal.pone.0327677. eCollection 2025.
New HIV infections are increasing among heterosexual Black and Latino populations in the United States, yet little is known about the shared characteristics of HIV risk behaviors and oral PrEP use among these populations. This study sought to understand factors influencing HIV risk behaviors and oral PrEP use among low income, limited English proficient (LEP), Black and Latino men with heterosexual contact in New York City (NYC).
Sixteen Black and Latino cisgender men with heterosexual contact and indication for PrEP were recruited from an urban safety net hospital in NYC between 2021 and 2022. In-depth interviews were conducted with participants in English and Spanish. Thematic content analysis was conducted.
Participants described multi-faceted experiences around PrEP use informed by HIV stigma, limited understanding of PrEP, and PrEP attitudes from participants and their social networks. Participants' HIV risk behaviors were informed by sexual decision making rooted in hegemonic masculinity, trust, and perceived HIV and STI susceptibility. Participants disclosed the mixed and diverse nature of their sexual networks (i.e., cisgender women, gay men, transgender women, and sex workers). Among LEP Spanish-speaking participants, HIV risk behaviors were contextually embedded in histories of sexual or physical abuse, child labor, and/or substance use problems.
Our results call for interventions that improve sexual health knowledge, reduce stigma, and foster open discussions around sexual networks. Combined, these interventions may contribute to more accurate understanding of HIV risk behaviors and reduction of HIV transmission, especially among communities impacted by sociopolitical disenfranchisement such as LEP Spanish-speakers.
在美国，异性恋黑人和拉丁裔人群中的新艾滋病毒感染病例正在增加，但对于这些人群中艾滋病毒风险行为和口服暴露前预防（PrEP）使用的共同特征知之甚少。本研究旨在了解影响纽约市低收入、英语水平有限（LEP）、有异性接触的黑人和拉丁裔男性的艾滋病毒风险行为和口服PrEP使用的因素。
2021年至2022年期间，从纽约市一家城市安全网医院招募了16名有异性接触且有PrEP指征的黑人和拉丁裔顺性别男性。用英语和西班牙语对参与者进行了深入访谈。进行了主题内容分析。
参与者描述了围绕PrEP使用的多方面经历，这些经历受到艾滋病毒污名、对PrEP的有限理解以及参与者及其社交网络对PrEP的态度的影响。参与者的艾滋病毒风险行为受到植根于霸权男性气质、信任以及感知到的艾滋病毒和性传播感染易感性的性决策的影响。参与者透露了他们性网络的混合和多样性（即顺性别女性、男同性恋者、跨性别女性和性工作者）。在英语水平有限的讲西班牙语的参与者中，艾滋病毒风险行为在性虐待或身体虐待、童工和/或物质使用问题的历史中有着背景嵌入。
我们的结果呼吁采取干预措施，以提高性健康知识、减少污名，并促进围绕性网络的公开讨论。综合起来，这些干预措施可能有助于更准确地理解艾滋病毒风险行为并减少艾滋病毒传播，特别是在受社会政治剥夺权利影响的社区，如英语水平有限的讲西班牙语者。
