Perspectives and experiences regarding pre-exposure prophylaxis (PrEP) in a community sample of Veterans with unhealthy alcohol use: overall and across sexual orientation and gender identity.

IF 3.2 2区 医学 Q1 SUBSTANCE ABUSE
Olivia V Fletcher, Kristine Beaver, Elizabeth J Austin, Jenna van Draanen, E Jennifer Edelman, Emily C Williams
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引用次数: 0

Abstract

Background: Unhealthy alcohol use is an independent, modifiable risk factor for HIV, but limited research addresses alcohol use and HIV prevention synergistically. Groups that experience chronic stigma, discrimination, and/or other marginalization, such as sexual and gender minoritized groups, may have enhanced HIV risk related to unhealthy alcohol use. We described awareness of and experiences with pre-exposure prophylaxis (PrEP) among a community sample of Veterans reporting unhealthy alcohol use (relative to those without), overall and across self-reported sexual orientation and gender identity.

Methods: Using data collected from a national online survey of Veterans recruited via Facebook ads, community organizations, and listservs, we assessed variation in four PrEP outcomes (knowledge, experience, willingness, and conversations with doctors) across patterns of unhealthy alcohol use among all respondents reporting any lifetime drinking (n = 1,041) and then within sexual orientation and gender identity groups using Chi-square or Fisher's exact tests.

Results: Among 1,041 eligible Veterans, 440 (42%) screened positive for unhealthy alcohol use. Veterans with unhealthy alcohol use were not more likely to have heard of PrEP (58.2% vs. 55.4%, p = 0.37), but trended toward more likely to have taken PrEP (7.5% vs. 5.0%, p = 0.09), to be willing to take PrEP (30.5% vs. 27.6%, p = 0.06), and to have spoken with a doctor about PrEP (11.4% vs. 7.7%, p = 0.04). Those with heavy episodic drinking also trended toward higher prevalence of PrEP awareness (60.0% vs. 54.6%, p = 0.09), and were more likely to have taken PrEP (8.3% vs. 4.7%, p = 0.02), to be willing to use PrEP (34.6% vs. 25.5%, p < 0.01), and to have had conversations with doctors about PrEP (12.7% vs. 7.2%, p < 0.01). Similar patterns were observed for severe unhealthy alcohol use and past-year frequent heavy episodic drinking. Generally, sexual/gender minoritized Veterans with unhealthy alcohol use reported more PrEP-affirming responses than those without but associations with unhealthy alcohol use were similar.

Conclusions: Unhealthy alcohol use was prevalent, particularly among Veterans with minoritized sexual orientation/gender identity, but not clearly linked to increased PrEP-literacy and use despite its known status as an HIV risk factor. Across groups, > 25% of individuals were willing to take PrEP. Interventions targeting both alcohol use and HIV prevention should capitalize on this.

Abstract Image

不健康饮酒退伍军人社区样本暴露前预防(PrEP)的观点和经验:总体和跨性取向和性别认同
背景:不健康的酒精使用是一个独立的、可改变的艾滋病毒风险因素,但有限的研究涉及酒精使用和艾滋病毒预防的协同作用。长期遭受耻辱、歧视和/或其他边缘化的群体,如性和性别少数群体,可能会增加与不健康饮酒有关的艾滋病毒风险。我们描述了在报告不健康饮酒的退伍军人社区样本中(相对于那些没有)对暴露前预防(PrEP)的认识和经验,总体上和自我报告的性取向和性别认同。方法:使用通过Facebook广告、社区组织和listservs招募的全国退伍军人在线调查收集的数据,我们评估了所有报告终身饮酒的受访者(n = 1041)在不健康饮酒模式下的四项PrEP结果(知识、经验、意愿和与医生的对话)的变化,然后使用卡方检验或Fisher精确检验评估了性取向和性别认同群体。结果:在1041名符合条件的退伍军人中,440名(42%)筛查出不健康饮酒阳性。不健康饮酒的退伍军人不太可能听说过PrEP(58.2%对55.4%,p = 0.37),但倾向于更有可能采取PrEP(7.5%对5.0%,p = 0.09),愿意采取PrEP(30.5%对27.6%,p = 0.06),并与医生谈论PrEP(11.4%对7.7%,p = 0.04)。重度间歇性饮酒者也倾向于更高的PrEP意识患病率(60.0%对54.6%,p = 0.09),并且更有可能采取PrEP(8.3%对4.7%,p = 0.02),愿意使用PrEP(34.6%对25.5%,p)结论:不健康的酒精使用是普遍存在的,特别是在少数性取向/性别认同的退伍军人中,但与PrEP读写和使用的增加没有明确的联系,尽管它是已知的HIV风险因素。在各个群体中,大约25%的人愿意采取预防措施。针对酒精使用和预防艾滋病毒的干预措施应利用这一点。
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来源期刊
Addiction Science & Clinical Practice
Addiction Science & Clinical Practice Psychology-Clinical Psychology
CiteScore
3.90
自引率
10.80%
发文量
64
审稿时长
28 weeks
期刊介绍: Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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