"Protected Means Armed": Perspectives on Pre-Exposure Prophylaxis (PrEP) Among Women Who Engage in Sex Work and Use Drugs in Kazakhstan.

IF 1.6 4区医学 Q2 EDUCATION & EDUCATIONAL RESEARCH

Aids Education and Prevention Pub Date : 2023-10-01 DOI:10.1521/aeap.2023.35.5.347

Tara McCrimmon, Victoria Frye, Meruyert Darisheva, Laura Starbird, Olivia Cordingley, Assel Terlikbayeva, Sholpan Primbetova, Louisa Gilbert, Nabila El-Bassel, Brooke S West

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Abstract

Pre-exposure prophylaxis (PrEP) for HIV prevention has recently become available in Kazakhstan, but women engaged in sex work who use drugs (WESW-UD) could benefit from tailored approaches to support uptake and adherence. To better understand how best to support WESW-UD at each stage of the PrEP continuum (awareness, acceptability, uptake, and adherence), we analyzed data from 30 in-depth interviews and four focus groups with 48 WESW-UD from two cities in Kazakhstan. We conducted thematic analysis to characterize perceptions, barriers, and motivators within each step of the PrEP continuum. Participants reported low awareness, but high interest in PrEP. Motivating factors included optimizing health and increased confidence. Participants expressed many preferences and concerns regarding PrEP modality and delivery. Participants also described how organizational mistrust and social support can prevent or facilitate PrEP uptake or adherence. Kazakhstan's scale-up of PrEP should consider the needs and preferences of WESW-UD to ensure equitable access.

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“受保护意味着武装”：哈萨克斯坦从事性工作和吸毒妇女暴露前预防（PrEP）的展望。

哈萨克斯坦最近提供了用于预防艾滋病毒的暴露前预防（PrEP），但从事性工作并使用药物的妇女（WESW-UD）可以从有针对性的方法中受益，以支持吸收和坚持。为了更好地了解如何在PrEP连续体的每个阶段（意识、可接受性、接受性和依从性）最好地支持WESW-UD，我们分析了来自哈萨克斯坦两个城市的30个深度访谈和4个焦点小组的数据，共有48个WESW-UD。我们进行了主题分析，以描述PrEP连续体每一步中的感知、障碍和激励因素。参与者对PrEP的认识较低，但兴趣较高。激励因素包括优化健康和增强信心。与会者对PrEP模式和交付方式表达了许多偏好和关切。参与者还描述了组织的不信任和社会支持如何阻止或促进PrEP的吸收或坚持。哈萨克斯坦扩大PrEP应考虑WESW-UD的需求和偏好，以确保公平获取。

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来源期刊

Aids Education and Prevention Multiple-

CiteScore

2.20

自引率

5.60%

发文量

期刊介绍： Presenting state-of-the-art research and information, AIDS Education and Prevention is a vital addition to the library collections of medical schools, hospitals, and other institutions and organizations with HIV/AIDS research programs. The journal integrates public health, psychosocial, sociocultural, and public policy perspectives on issues of key concern nationally and globally.