Intention to Use Different Formulations of Longer Acting HIV Pre-Exposure Prophylaxis Among Transgender and Gender Expansive Individuals: The Roles of Social Vulnerability and Medical Mistrust.

IF 3.4 2区 医学 Q2 INFECTIOUS DISEASES AIDS patient care and STDs Pub Date : 2024-02-01 DOI:10.1089/apc.2023.0211
Phillip W Schnarrs, Julie Zuñiga, Gabrielle Benitez, Paul Fliedner, Aliza Norwood, Madeleine Croll, Liany D Serrano Oviedo, Jacey Buchorn, John Oeffinger, Rocky Lane, Emmett Schelling, Gin Pham, TreShaun Pate, Elizabeth M Arnold
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Abstract

In 2012, the Federal Drug Administration approved daily oral pre-exposure prophylaxis (PrEP) for HIV prevention in adults. Longer acting injectable PrEP (LA PrEP) has been approved and other formulations are in development. A successful LA PrEP rollout requires examining potential facilitators and barriers to PrEP uptake. Given that transgender and gender expansive (TGE) individuals experience more social vulnerability and higher levels of medical mistrust compared to other populations, examining the role of these two factors in LA PrEP uptake is important. This study, PrEP for ALL, is a community-based participatory research project in Texas that engaged TGE community members and organizational partners through a community advisory board. In total, 482 TGE individuals were recruited and responded to all relevant questions in an online survey, including their intentions to use three formulations: a monthly oral pill, a bimonthly intramuscular injection, and an annual subdermal implant. Multiple regression analysis was used to examine the influence of social vulnerability and medical mistrust on intention to use each LA PrEP formulation adjusting for other relevant factors. Findings suggest that individuals with higher levels of social vulnerability had greater intentions to use the monthly oral pill (β = 0.12, p = 0.009), the bimonthly intramuscular injection (β = 0.18, p < 0.001), and annual subdermal implant (β = 0.17, p < 0.001), whereas medical mistrust reduced intentions to use the bimonthly intramuscular injection (β = -0.18, p < 0.001) and annual subdermal implant (β = -0.11, p = 0.021). Improvements in gender-affirming clinical care are needed along with LA PrEP formulations that allow for greater autonomy and reduced clinical contact. Clinical Trial Registration number: NCT05044286.

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变性人和性别扩张者使用不同配方的长效艾滋病暴露前预防剂的意向:社会脆弱性和医疗不信任的作用。
2012 年,美国联邦药品管理局批准了用于成人艾滋病预防的每日口服暴露前预防药物 (PrEP)。长效注射 PrEP(LA PrEP)已获批准,其他制剂正在开发中。要成功推广长效注射 PrEP,就必须对 PrEP 摄入的潜在促进因素和障碍进行研究。与其他人群相比,变性者和性别扩张者(TGE)的社会脆弱性更高,对医疗的不信任程度也更高,因此研究这两个因素在 LA PrEP 摄入中的作用非常重要。这项名为 "PrEP for ALL "的研究是德克萨斯州的一项社区参与式研究项目,该项目通过社区咨询委员会吸引了 TGE 社区成员和组织合作伙伴的参与。共招募了 482 名 TGE 个人,他们回答了在线调查中的所有相关问题,包括他们使用三种制剂的意向:每月一次的口服药、每两个月一次的肌肉注射和每年一次的皮下植入。在对其他相关因素进行调整后,采用多元回归分析法研究了社会脆弱性和医疗不信任对使用每种 LA PrEP 配方的意向的影响。研究结果表明,社会脆弱性程度较高的人更愿意使用每月一次的口服药(β = 0.12,p = 0.009)和每两个月一次的肌肉注射(β = 0.18,p β = 0.17,p β = -0.18,p β = -0.11,p = 0.021)。需要改进性别肯定的临床护理,以及允许更大自主权和减少临床接触的 LA PrEP 配方。临床试验注册号:NCT05044286:NCT05044286。
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来源期刊
AIDS patient care and STDs
AIDS patient care and STDs 医学-传染病学
CiteScore
7.00
自引率
22.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world. AIDS Patient Care and STDs coverage includes: Prominent AIDS medications, therapies, and antiretroviral agents HIV/AIDS-related diseases, infections, and complications Challenges of medication adherence Current prevention techniques for HIV The latest news and developments on other STDs Treatment/prevention options, including pre- and post-exposure prophylaxis
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