关系的变化,艾滋病毒风险和对PrEP的感受:来自CHARISMA干预试验参与者的定性解释性研究的发现
Miriam Hartmann1,2, Noah Triplett3, Sarah T Roberts3
1Women's Global Health Imperative, RTI International, Berkeley, California, USA. mhartmann@rti.org.
BMC women's health
|August 23, 2023
概括
CHARISMA干预改善了女性的关系和赋权,但并没有显著增加艾滋病毒预防的暴露前预防 (PrEP) 坚持. 一些女性停止了PrEP,因为他们的关系有所改善,这可能解释了无效结果.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 定性研究是指质量研究.
背景情况:
- 亲密伴侣暴力 (IPV) 和关系挑战阻碍了妇女有效使用暴露前预防 (PrEP) 预防艾滋病毒.
- 该CHARISMA干预旨在通过解决这些关系障碍来增强南非妇女使用PrEP的代理权.
- 之前的一项随机对照试验发现,CHARISMA干预和对照组之间的PrEP坚持或关系动态没有显著差异.
研究的目的:
- 在CHARISMA试验中质量地探索女性的经历.
- 了解CHARISMA随机对照试验中关于PrEP坚持和关系动态的无效结果背后的原因.
主要方法:
- 一项定性子研究,涉及对12名CHARISMA试验参与者的连续深度访谈.
- 参与者从干预组 (接受健康沟通,PrEP披露或IPV咨询) 和控制组 (接受标准IPV护理) 中进行了选择.
- 在试验结束时进行了采访,并在3个月后再次进行了采访.
主要成果:
- 干预参与者报告了积极的关系结果,包括结束不健康的关系和增加个人赋权.
- 参与者在新的关系中实施了改善的行为和艾滋病毒风险降低策略.
- 积极关系的转变有时导致决定停止使用PrEP,这可能解释了干预对坚持治疗的影响有限.
结论:
- 解决PrEP使用关系障碍的咨询干预措施可以为女性带来显著的个人和关系改善.
- 在人际关系和赋权方面观察到的积极转变可能会影响人们对PrEP的感知需求,有助于遵守结果.
- 未来的研究应该考虑不断变化的风险动态和PrEP需求,在设计针对基于关系的HIV预防障碍的干预措施时.
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