在黑人和西班牙裔/拉丁裔MSM中,缺乏对医生的不信任和愿意使用长效PrEP
Jerris L Raiford1, Robin J MacGowan2, Rob Stephenson3
1Division of HIV/AIDS Prevention, HIV Research Branch, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, 1600 Clifton Road NE, Mailstop E-37, Atlanta, GA, 30333, USA. jraiford@cdc.gov.
AIDS and behavior
|July 7, 2025
概括
医疗不信任阻碍了与男性发生性关系的黑人男性 (MSM) 采用长期作用的暴露前预防药物 (LA PrEP). 解决这种不信任对于有效预防艾滋病毒和减少健康差距至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 同性恋,双性恋和其他与男性发生性关系的男性 (MSM),特别是黑人MSM (BMSM) 和西班牙裔/拉丁裔MSM (HLMSM),在美国面临着不成比例的高艾滋病毒感染率.
- 长效暴露前预防 (LA PrEP) 提供了一种有效的艾滋病毒预防策略,但其吸收可能受到这些社区内医疗不信任的限制.
研究的目的:
- 调查BMSM和HLMSM中医疗不信任和愿意使用LA PrEP之间的联系.
- 在高风险人群中识别对LA PrEP采用的潜在障碍.
主要方法:
- 一项研究涉及1,126名BMSM和924名HLMSM (年龄≥18,没有先前的HIV诊断或PrEP使用) 通过在线平台招募.
- 使用波桑回归的多变量分析评估了医疗不信任与愿意使用注射或植入LA PrEP之间的联系,并单独分析每个种族/民族群体.
主要成果:
- 虽然超过90%的人表示愿意使用PrEP的某种形式,但对LA PrEP的意愿不同:BMSM的74%和HLMSM的81%用于注射;只有30%的BMSM和44%的HLMSM用于植入物.
- 在对共变量进行调整后,医疗不信任与BMSM中使用LA PrEP的意愿较低显著相关,但不是HLMSM.
结论:
- 减少对医生的不信任对于增加LA PrEP在BMSM中的吸收至关重要,从而提高艾滋病毒预防的有效性.
- 解决系统性问题和培养对医疗保健的信任对于减轻BMSM和HLMSM之间的HIV差异至关重要.
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