Lydia Jacenta Nakiganda, Benjamin R Bavinton, Isobel Mary Poynten, David Serwadda, Jeremiah Mulamba Bazaale, Andrew E Grulich
{"title":"乌干达西南部接受口服暴露前预防疗法的女性性工作者的性快感和与艾滋病毒有关的担忧。","authors":"Lydia Jacenta Nakiganda, Benjamin R Bavinton, Isobel Mary Poynten, David Serwadda, Jeremiah Mulamba Bazaale, Andrew E Grulich","doi":"10.1071/SH23056","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Female sex workers (FSWs) contribute disproportionately to HIV transmission in Uganda, and pre-exposure prophylaxis (PrEP) is effective in preventing HIV among cisgender women. Psychological factors are important for PrEP uptake, but few studies have examined psychosocial changes due to PrEP use in Uganda.</p><p><strong>Methods: </strong>In 2021, we recruited 524 FSWs in three Trans-African Highway towns and four fishing communities in south-western Uganda. We conducted structured interviews among women who were attending routine PrEP follow-up visits in six health units. Bivariable and multivariable modified regression using a robust covariance matrix estimator were used to identify factors associated with experiencing increased sexual pleasure and less worry about HIV because of PrEP.</p><p><strong>Results: </strong>Overall, 80.9% participants reported that sex was more pleasurable because of taking PrEP. There were statistical trends for sex being more pleasurable when taking PrEP or when having condomless sex with casual paying partners (aPR=1.19, 95% CI=1.07-1.32, P =0.001). Almost three-quarters of the participants (76.3%) were less worried about getting HIV because of PrEP. Condomless sex with casual paying partners (aPR=1.17, 95% CI=1.05-1.31, P =0.032, P =0.003) and being On PrEP for the past 1-2years (aPR=1.18, 95% CI=1.00-1.38, P =0.032) was significantly associated with HIV-related worry (aPR=1.17, 95% CI=1.05-1.31, P =0.032, P =0.003) Conclusions : We found a positive impact of PrEP in Ugandan FSWs on two key psychosocial dimensions: (1) more pleasurable sex; and (2) less worry about acquiring HIV. Interventions aiming to increase PrEP uptake may find it useful to focus on psychosocial dimensions.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sexual pleasure and HIV-related worry in female sex workers on oral pre-exposure prophylaxis in south-western Uganda.\",\"authors\":\"Lydia Jacenta Nakiganda, Benjamin R Bavinton, Isobel Mary Poynten, David Serwadda, Jeremiah Mulamba Bazaale, Andrew E Grulich\",\"doi\":\"10.1071/SH23056\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Female sex workers (FSWs) contribute disproportionately to HIV transmission in Uganda, and pre-exposure prophylaxis (PrEP) is effective in preventing HIV among cisgender women. Psychological factors are important for PrEP uptake, but few studies have examined psychosocial changes due to PrEP use in Uganda.</p><p><strong>Methods: </strong>In 2021, we recruited 524 FSWs in three Trans-African Highway towns and four fishing communities in south-western Uganda. We conducted structured interviews among women who were attending routine PrEP follow-up visits in six health units. Bivariable and multivariable modified regression using a robust covariance matrix estimator were used to identify factors associated with experiencing increased sexual pleasure and less worry about HIV because of PrEP.</p><p><strong>Results: </strong>Overall, 80.9% participants reported that sex was more pleasurable because of taking PrEP. There were statistical trends for sex being more pleasurable when taking PrEP or when having condomless sex with casual paying partners (aPR=1.19, 95% CI=1.07-1.32, P =0.001). Almost three-quarters of the participants (76.3%) were less worried about getting HIV because of PrEP. Condomless sex with casual paying partners (aPR=1.17, 95% CI=1.05-1.31, P =0.032, P =0.003) and being On PrEP for the past 1-2years (aPR=1.18, 95% CI=1.00-1.38, P =0.032) was significantly associated with HIV-related worry (aPR=1.17, 95% CI=1.05-1.31, P =0.032, P =0.003) Conclusions : We found a positive impact of PrEP in Ugandan FSWs on two key psychosocial dimensions: (1) more pleasurable sex; and (2) less worry about acquiring HIV. 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引用次数: 0
摘要
背景:在乌干达,女性性工作者(FSWs)在 HIV 传播中的比例过高,而接触前预防疗法(PrEP)可有效预防同性女性感染 HIV。心理因素对 PrEP 的采用非常重要,但很少有研究对乌干达因使用 PrEP 而产生的社会心理变化进行研究:2021 年,我们在乌干达西南部的三个泛非公路城镇和四个渔业社区招募了 524 名女性同性恋者。我们在六个医疗单位对参加 PrEP 常规随访的女性进行了结构化访谈。我们使用稳健协方差矩阵估计器进行了二变量和多变量修正回归,以确定与因 PrEP 而增加性快感和减少对 HIV 的担忧相关的因素:总体而言,80.9%的参与者表示由于服用了 PrEP,性生活更加愉悦。有统计趋势表明,在服用 PrEP 或与临时付费伴侣进行无套性行为时,性生活会更加愉悦(aPR=1.19,95% CI=1.07-1.32,P=0.001)。近四分之三的参与者(76.3%)因为服用了 PrEP 而减少了对感染 HIV 的担忧。与临时付费伴侣发生的无保险套性行为(aPR=1.17,95% CI=1.05-1.31,P=0.032,P=0.003)和在过去 1-2 年中接受过 PrEP 治疗(aPR=1.18,95% CI=1.00-1.38,P=0.032)与艾滋病相关担忧显著相关(aPR=1.17,95% CI=1.05-1.31,P=0.032,P=0.003)。结论:我们发现,PrEP 对乌干达的 FSWs 在两个关键的社会心理方面产生了积极的影响:(1)性生活更加愉悦;(2)对感染 HIV 的担忧减少。旨在提高 PrEP 使用率的干预措施可能会发现关注社会心理层面是有益的。
Sexual pleasure and HIV-related worry in female sex workers on oral pre-exposure prophylaxis in south-western Uganda.
Background: Female sex workers (FSWs) contribute disproportionately to HIV transmission in Uganda, and pre-exposure prophylaxis (PrEP) is effective in preventing HIV among cisgender women. Psychological factors are important for PrEP uptake, but few studies have examined psychosocial changes due to PrEP use in Uganda.
Methods: In 2021, we recruited 524 FSWs in three Trans-African Highway towns and four fishing communities in south-western Uganda. We conducted structured interviews among women who were attending routine PrEP follow-up visits in six health units. Bivariable and multivariable modified regression using a robust covariance matrix estimator were used to identify factors associated with experiencing increased sexual pleasure and less worry about HIV because of PrEP.
Results: Overall, 80.9% participants reported that sex was more pleasurable because of taking PrEP. There were statistical trends for sex being more pleasurable when taking PrEP or when having condomless sex with casual paying partners (aPR=1.19, 95% CI=1.07-1.32, P =0.001). Almost three-quarters of the participants (76.3%) were less worried about getting HIV because of PrEP. Condomless sex with casual paying partners (aPR=1.17, 95% CI=1.05-1.31, P =0.032, P =0.003) and being On PrEP for the past 1-2years (aPR=1.18, 95% CI=1.00-1.38, P =0.032) was significantly associated with HIV-related worry (aPR=1.17, 95% CI=1.05-1.31, P =0.032, P =0.003) Conclusions : We found a positive impact of PrEP in Ugandan FSWs on two key psychosocial dimensions: (1) more pleasurable sex; and (2) less worry about acquiring HIV. Interventions aiming to increase PrEP uptake may find it useful to focus on psychosocial dimensions.
期刊介绍:
Sexual Health publishes original and significant contributions to the fields of sexual health including HIV/AIDS, Sexually transmissible infections, issues of sexuality and relevant areas of reproductive health. This journal is directed towards those working in sexual health as clinicians, public health practitioners, researchers in behavioural, clinical, laboratory, public health or social, sciences. The journal publishes peer reviewed original research, editorials, review articles, topical debates, case reports and critical correspondence.
Officially sponsored by:
The Australasian Chapter of Sexual Health Medicine of RACP
Sexual Health Society of Queensland
Sexual Health is the official journal of the International Union against Sexually Transmitted Infections (IUSTI), Asia-Pacific, and the Asia-Oceania Federation of Sexology.