激励坚持性别确认PrEP计划:跨性别和性别非二进制成年人之间的声明偏好离散选择实验
Marta G Wilson-Barthes1, Arjee Javellana Restar2, Don Operario3
1Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
概括
包括现金和注射激素共同处方在内的有条件经济激励措施是可以接受的,以改善跨性别成年人长期注射暴露前预防 (LA-PrEP) 的坚持. 这些激励措施可能对收入较低的年轻人最有效.
科学领域:
- 公共卫生 公共卫生
- 行为科学 行为科学
- 预防艾滋病毒 预防艾滋病毒
背景情况:
- 跨性别者面临不成比例的高艾滋病毒风险,但对暴露前预防 (PrEP) 的坚持仍然很低.
- 障碍包括与性别相关的耻辱,经济挑战,以及对与艾滋病毒药物激素相互作用的担忧.
研究的目的:
- 确定影响跨性别成年人坚持长期注射PrEP (LA-PrEP) 的关键因素.
- 评估LA-PrEP计划参与的有条件经济激励的可接受性.
主要方法:
- 一个离散选择实验 (DCE) 涉及华盛顿州385名跨性别成年人.
- 对提供LA-PrEP和性别肯定护理的假设激励计划的偏好评估.
- 分析使用排序的混合逻辑模型来确定愿意接受程序属性.
主要成果:
- 最佳的计划设计包括现金激励,通过血液检测确认遵守,面对面咨询和注射激素联合处方.
- 受访者愿意放弃相当大的金额 (现金为689美元,注射激素为547美元) 来获得这些首选属性.
- 随着年龄的增长 (>40岁) 和收入的增加 (>75000美元/年),项目接受率下降.
结论:
- 有条件的经济激励措施很可能是可以接受和有效的,以提高跨性别人口的LA-PrEP坚持.
- 激励计划可能特别有利于年轻的跨性别成年人,他们的财务资源较少.
- 建议通过随机试验进行进一步的研究,以验证DCE的发现,以预测实际的程序吸收.
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