在澳大利亚同性恋,双性恋和酷尔男性和非二进制人群中估计预防-有效遵守艾滋病毒暴露前预防 (PrEP):混合方法分析
James MacGibbon1, Anthony K J Smith2,3,4, Timothy R Broady2
1Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia. j.macgibbon@unsw.edu.au.
AIDS and behavior
|November 10, 2025
概括
近四分之一的同性恋,双性恋,酷尔男性和非二进制人群 (GBQ+) 使用艾滋病毒暴露前预防 (PrEP) 经历了由于错过剂量的PrEP未受保护的性行为. 坚持挑战与年龄,副作用和PrEP接入等因素有关.
科学领域:
- 公共卫生 公共卫生
- 预防艾滋病毒 预防艾滋病毒
- 性健康 性的健康
背景情况:
- 口服艾滋病毒暴露前预防 (PrEP) 在持续使用时,对预防艾滋病毒传播非常有效.
- 预防有效的坚持,定义为在艾滋病毒风险时期适当使用PrEP,对于PrEP的成功至关重要.
- 了解导致关键人群缺乏最佳依赖的因素,对于优化艾滋病毒预防策略至关重要.
研究的目的:
- 改进和验证一个简短的措施,以评估在同性恋,双性恋,同性恋男性和非二进制 (GBQ+) 人群中口服PrEP的预防有效遵守.
- 估计"与随意伴侣的未使用PrEP保护套的门性交" (CLAIC) 的患病率,并确定相关特征.
- 通过认知面试来评估坚持测量的可理解性.
主要方法:
- 一种混合方法的方法,结合了全国在线横截面调查 (n=2,046) 和定性认知访谈 (n=14).
- 使用后勤回归分析来识别 PrEP 用户报告"未受保护的 PrEP CLAIC"的特征.
- 认知面试评估了与遵守相关的调查项目的清晰度和可解释性.
主要成果:
- 在参与CLAIC的792名现有PrEP用户中,24.5%报告"PrEP不受保护的CLAIC"由于错过剂量.
- 与"未受PrEP保护的CLAIC"相关的因素包括年龄较小 (<30岁),最近启动PrEP,经历副作用,非日常使用PrEP和最近的性化药物使用.
- 报告"未受PrEP保护的CLAIC"的PrEP用户不太可能轻松获得PrEP.
结论:
- 这项研究提供了预防有效坚持的第一个国家估计,突出表明,相当一部分的GBQ+ PrEP用户经历了低于最佳的坚持.
- 对于报告频繁出现"未受保护的PrEP CLAIC"的子组,需要针对性干预,重点是解决副作用和其他坚持障碍.
- 精细的坚持度指标显示出可理解性,支持在未来的调查中使用它来监测PrEP的有效性.
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