Exploring perceptions and preferences for PrEP choice and of an mHealth intervention: insights from the ImPrEP CAB-Brasil study

IF 4.9 1区医学 Q2 IMMUNOLOGY

Journal of the International AIDS Society Pub Date : 2025-07-02 DOI:10.1002/jia2.26493

Cristina Pimenta, Claudio G. Mann, Brenda Hoagland, Eduardo Carvalheira, Cristina Jalil, Marcos Benedetti, Nilo Fernandes, Carolina Coutinho, Emilia M. Jalil, Mayara Secco Torres Silva, Roberta Trefiglio, Alessandro Farias, Maria Paula G. Mourão, José Valdez Madruga, Josué N. de Lima, Ronaldo Zonta, Gabrielle O'Malley, Valdilea G. Veloso, Beatriz Grinsztejn, Thiago S. Torres, for the ImPrEP CAB-Brasil Study

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引用次数: 0

Abstract

Introduction

Although the efficacy of long-acting injectable cabotegravir (CAB-LA) for pre-exposure prophylaxis (PrEP) is well-known from clinical trials, research is needed to guide effective strategies for its implementation. We describe a qualitative study to assess perceptions and preferences for PrEP choice and acceptability of an mHealth intervention within the ImPrEP CAB Brasil study.

Methods

ImPrEP CAB Brasil is an implementation study of same-day delivery of CAB-LA for young sexual and gender minorities (SGM; 18–30 years) in oral PrEP public health clinics in six Brazilian cities. At enrolment, participants received counselling on HIV prevention (SOC) or SOC+mHealth tool to choose between oral or injectable PrEP. The mHealth tool consisted of five videos describing HIV combined prevention including PrEP options. A subset of participants from each site were invited to participate in the qualitative study (October 2023−July 2024). Semi-structured interviews were conducted, recorded and transcribed. Data were fed into ATLAS.ti.24 software. Conventional content analysis was used for coding categories based on an inductive reasoning process.

Results

We conducted 120 interviews (48 SOC and 72 SOC+mHealth; 107 CAB-LA and 13 oral PrEP). Participants reported not knowing about CAB-LA before enrolment; some recently heard from a partner or friend. Reasons for choosing CAB-LA were perceived convenience, practicality, easier adherence to bimonthly injections and higher efficacy compared to oral PrEP. Reasons for not choosing CAB-LA were fear of injections and pain. Reasons for choosing oral PrEP included perspective of less appointments, easiness of daily adherence, access in case of travel and the option to stop immediately if desired or needed. Reasons for not choosing oral PrEP included forgetfulness of daily intake, gastrointestinal side effects, fear of inadvertent exposure and judgement by family. Participants found the mHealth educational tool useful and adequate for PrEP education and decision-making.

Conclusions

Perceptions for PrEP choice among SGM underscore the importance of providing comprehensive information and support towards decision-making processes, so users can have an accurate understanding of each PrEP option, as well as their clinical and social benefits. The mHealth tool was perceived as highly desirable and useful for PrEP education, having the potential to be implemented in HIV prevention services.

Clinical Trial Number

NCT05515770

Abstract Image

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探索对PrEP选择和移动健康干预的看法和偏好：来自ImPrEP cab -巴西研究的见解

虽然长效注射卡博特重力韦（CAB-LA）用于暴露前预防（PrEP）的疗效在临床试验中是众所周知的，但仍需要研究指导其有效的实施策略。在ImPrEP CAB巴西研究中，我们描述了一项定性研究，以评估对PrEP选择的看法和偏好以及移动健康干预的可接受性。方法ImPrEP CAB巴西是一项针对年轻性和性别少数群体(SGM；18-30岁)在巴西六个城市的口服预防PrEP公共卫生诊所。在入组时，参与者接受了艾滋病毒预防（SOC）或SOC+移动健康工具的咨询，以选择口服或注射PrEP。移动健康工具由五个视频组成，描述了包括PrEP选项在内的艾滋病毒联合预防。每个地点的一部分参与者被邀请参加定性研究（2023年10月至2024年7月）。进行了半结构化访谈，并进行了记录和转录。数据被输入ATLAS.ti。24软件。传统的内容分析被用于基于归纳推理过程的编码类别。结果共进行了120次访谈(48例SOC和72例SOC+mHealth；CAB-LA 107例，口服PrEP 13例)。参与者报告在入组前不了解CAB-LA；有些人最近从伴侣或朋友那里得到消息。选择caba - la的原因是认为与口服PrEP相比，caba - la方便、实用、更容易坚持每两个月注射一次、疗效更高。不选择caba - la的原因是害怕注射和疼痛。选择口服PrEP的原因包括预约较少、日常依从性容易、旅行时可获得以及在需要或需要时可立即停止。不选择口服PrEP的原因包括忘记每日摄入、胃肠道副作用、担心无意接触和家人的判断。与会者认为，移动健康教育工具对预防PrEP教育和决策很有用，也足够。结论：SGM对PrEP选择的认知强调了为决策过程提供全面信息和支持的重要性，以便用户能够准确了解每种PrEP选择及其临床和社会效益。人们认为移动健康工具对预防教育非常理想和有用，有可能在艾滋病毒预防服务中实施。临床试验编号NCT05515770

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来源期刊

Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

8.60

自引率

10.00%

发文量

186

审稿时长

>12 weeks

期刊介绍： The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.