一个竞争风险持续时间模型来研究法国MSM中PrEP停止:ERAS 2023研究
Clément Boutet1, Marion Di Ciaccio2,3, Bruno Spire2
1Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France. clement.boutet@ird.fr.
AIDS and behavior
|April 29, 2025
概括
艾滋病毒暴露前预防药物 (PrEP) 的高中止率限制了其有效性. 这项研究没有发现同性恋和双性恋男性中PrEP疲劳的证据,这表明特定的因素导致停止服用.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 性健康 性的健康
背景情况:
- 艾滋病毒暴露前预防药物 (PrEP) 的高停止率降低了其在风险人群中的有效性.
- 了解PrEP停药的原因对于改善艾滋病毒预防策略至关重要.
研究的目的:
- 调查法国与男性发生性关系的同性恋和双性恋男性 (GBMSM) 中PrEP停药的原因.
- 确定与PrEP停药的不同原因相关的因素,并评估PrEP疲劳.
主要方法:
- 来自法国在线调查Enquête Rapport au Sexe 2023的数据分析,其中包括4819个GBMSM.
- 构建"PrEP持续时间"和三个类别的"PrEP停用原因"变量 (性行为变化,停用愿望,临床原因).
- 应用Weibull加速失效时间模型与竞争风险来分析停产因素和持续时间依赖.
主要成果:
- 平均PrEP持续时间为19个月.
- 当PrEP在性健康结构中启动时,由于行为变化而中止的可能性较小.
- 在血清阳性率较低的地区,停止PrEP的愿望更有可能发生,在较小的市镇中,临床原因更为常见.
- 负持续时间依赖表明更长时间使用PrEP的中止概率较低.
结论:
- 在GBMSM中没有发现PrEP疲劳的证据.
- 特定的因素,而不是一般的疲劳,与PrEP停用有关.
- 需要针对行为,地理和临床因素进行量身定制的干预措施,以改善PrEP的坚持和有效性.
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