Men's Voices on Long-Acting Pre-Exposure Prophylaxis Delivery Modalities: Acceptability and Preferences Among Cisgender Men and Men Who Have Sex With Men in South Africa.

IF 2.9 3区 医学 Q3 IMMUNOLOGY
Millicent Atujuna, Alinda M Nyamaizi, Zoe Duby, Alexandra Minnis, Miranda Diaz, Thesla Palanee-Phillips, Siyanda Tenza, Krishnaveni Reddy, Nqaba Nkomana, Linda-Gail Bekker, Elizabeth Montgomery
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Abstract

Introduction: In sub-Saharan Africa, cisgender men-in particular men who have sex with women (MSW) and, to a lesser degree, men who have sex with men (MSM)-are often under-represented in HIV prevention research, despite their own HIV risk and role in transmission cycles. As HIV prevention research on long-acting pre-exposure prophylaxis (LA PrEP) options expands in sub-Saharan Africa, it is essential to engage these populations to ensure their acceptability. We investigated perceptions of implants and intramuscular injectables as LA PrEP delivery among MSW and MSM.

Methods: In-depth interviews were conducted between October 2020 and March 2021 with 40 MSW (n = 20) and MSM (n = 20), aged 18-35 years, self-reported as HIV negative, sexually active, and residing in resource-restricted communities in Cape Town and Johannesburg, South Africa. We explored factors influencing LA PrEP attitudes. Data analysis followed a thematic framework approach.

Results: MSW and MSM found LA PrEP administration modes more acceptable than daily oral PrEP because they offered longer lasting protection while reducing frequent clinic visits for refills. MSW voiced hesitancy around the use of "foreign products," fearing infertility and congenital disabilities in their future children. Both subgroups acknowledged the convenience of implants with long-dosing duration, but injections were deemed to be more discrete and familiar. Both groups described implant use as potentially stigmatizing, with a greater chance of causing tissue scarring from insertion and removal procedures.

Conclusions: Evidence relating to men's engagement in HIV prevention and acceptable modalities of HIV prevention is limited. We found that both groups were enthusiastic about LA PrEP, informing the development of our subsequent clinical study to provide further insight into using placebo versions of LA PrEP and future implementation of LA PrEP options.

男性对长效暴露前预防给药方式的声音:南非顺性男性和男男性行为者的可接受性和偏好。
导言:在撒哈拉以南非洲,顺性男性——特别是与女性发生性行为的男性(MSW),以及在较小程度上与男性发生性行为的男性(MSM)——在艾滋病毒预防研究中的代表性往往不足,尽管他们自身存在艾滋病毒风险并在传播周期中发挥作用。随着针对长效暴露前预防(LA PrEP)方案的艾滋病毒预防研究在撒哈拉以南非洲扩大,有必要让这些人群参与进来,以确保其可接受性。我们调查了在城市生活垃圾和男男性行为者中,植入物和肌肉注射作为LA PrEP递送的感知。方法:在2020年10月至2021年3月期间,对40名年龄在18-35岁、自报HIV阴性、性活跃、居住在南非开普敦和约翰内斯堡资源受限社区的MSW (n = 20)和MSM (n = 20)进行了深度访谈。我们探讨了影响LA PrEP态度的因素。数据分析采用主题框架方法。结果:MSW和MSM认为LA PrEP给药模式比每日口服PrEP更容易接受,因为它们提供更持久的保护,同时减少了频繁的诊所就诊。MSW对使用“外国产品”表示犹豫,担心他们未来的孩子不孕和先天性残疾。两个亚组都承认长剂量植入物的便利性,但注射被认为是更离散和熟悉的。两组人都认为植入物的使用有潜在的污名化,更有可能在植入和移除过程中造成组织疤痕。结论:有关男性参与艾滋病毒预防和可接受的艾滋病毒预防方式的证据有限。我们发现两组患者都对LA PrEP充满热情,这为我们后续临床研究的发展提供了信息,以进一步了解使用安慰剂版本的LA PrEP和LA PrEP选项的未来实施。
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来源期刊
CiteScore
5.80
自引率
5.60%
发文量
490
审稿时长
3-6 weeks
期刊介绍: JAIDS: Journal of Acquired Immune Deficiency Syndromes​ seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide. JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.
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