HIV暴露前予防の使用に対する州レベルの政策環境の効果と内定された汚名を伴う役割
Nicole K Kelly1,2, Shabbar I Ranapurwala1, Brian W Pence1
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Journal of acquired immune deficiency syndromes (1999)
|September 4, 2025
まとめ
より公平な国家政策により,性的およびジェンダーマイノリティ化された (SGM) 若者における暴露前予防 (PrEP) の使用が14%増加し,HIV感染が減少する可能性があります. この効果は黒人の参加者にとって最も顕著でした.
科学分野:
- 公衆衛生
- 健康政策
- 流行病学
背景:
- レズビアン,ゲイ,バイセクシュアル,トランスジェンダー,および/またはクィア (LGBTQ+) に対する法律は,米国で増加しており,性的およびジェンダーマイノリティー (SGM) の若者に影響を及ぼしています.
- 特にHIV予防に関するSGMの若者に対する差別的な法律の健康への影響は十分に研究されていない.
研究 の 目的:
- SGMの若者および若者における暴露前予防 (PrEP) への仮設的公平なLGBTQ+政策の影響を推定する.
- LGBTQ+政策と PrEPの使用の関係を 内部化された汚名を調停するかどうかを調査する.
主な方法:
- HIVリスクが高い3330人のSGM患者 (年齢13~34歳) を含む全国的な"Keeping it LITE-1"コホート (2017~2022年) の分析
- 参加者の地理位置データを州レベルのLGBTQ+政策スコアとリンクし,法律を差別的か差別的かに分類する.
- 自己報告されたPrEP使用に対する国家政策環境の平均的な治療効果と,内在的な汚名を減らす制御された直接効果を推定する.
主要な成果:
- 差別的でないLGBTQ+政策への仮説的な移行は,SGMの若者と若者の間でPrEPの使用が14%増加したとの関連がありました.
- このPrEP使用の増加は,黒人参加者の間で最も顕著で,23%の増加を示しました.
- 内部化された汚名を減らすことは,政策環境とPrEPの使用との関連を大きく変えなかった.
結論:
- 公平な州レベルのLGBTQ+政策は 国内でのPrEPの普及を大幅に促進し HIV感染率を減らすことができます
- 差別的な法律の廃止と保護政策の制定は,SGMの若者の間で人口レベルのHIV感染の減少に不可欠です.
- 州レベルでのLGBTQ+の権利を対象とした政策介入は,HIV予防の成果を改善するための有望な道を示しています.
関連する概念動画
Sexually Transmitted Infections
410
Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
410
Stereotypes, Prejudice, and Discrimination
91.4K
Humans are very diverse and although we share many similarities, we also have many differences. The social groups we belong to help form our identities (Tajfel, 1974). These differences may be difficult for some people to reconcile, which may lead to prejudice toward people who are different. Prejudice is a negative attitude and feeling toward an individual based solely on one’s membership in a particular social group (Allport, 1954; Brown, 2010). Prejudice is common against people who...
91.4K
Factors Affecting the Risk of Infection
12.2K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
12.2K
Transmission-based Precautions II: Airborne and Protective Environment
1.5K
Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
1.5K
Healthcare Associated Infections II: Preventive Measures
2.8K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.8K
Stress and Mental Health
211
Chronic stress profoundly affects mental health, significantly influencing mood, behavior, and overall quality of life. Research closely links chronic stress with mental health conditions such as depression, anxiety, and substance use disorders. Ongoing exposure to stress can lead to physiological and psychological changes, initiating a cycle of emotional distress and maladaptive coping mechanisms.
Individuals with depression often experience challenges in both their personal and professional...
Individuals with depression often experience challenges in both their personal and professional...
211


