艾滋病毒暴露前预防疗法 (PrEP) 使用者在 COVID-19 大流行期间对 PrEP 获取、性行为和福祉的体验:威尔士定性研究

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Zahraa Khammas, David Gillespie, Adam Dale Newman Williams, Jane Nicholls, Fiona Wood
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引用次数: 0

摘要

背景 自 2017 年起,威尔士开始提供艾滋病毒暴露前预防疗法 (PrEP)。冠状病毒病(COVID-19)大流行影响了英国的性健康服务,导致服务供应减少。在此期间,缺乏对 PrEP 用户体验的研究。 目标 我们旨在探讨威尔士 PrEP 用户在 COVID-19 大流行措施出台后的经历。 方法 我们对之前的两项访谈研究(DO-PrEP 和 UPrEP)进行了二次数据分析。数据收集工作于 2020 年 5 月至 2021 年 2 月期间通过远程访谈进行。我们进行了半结构化访谈。参与者年龄≥18 岁,为威尔士居民,目前或曾经使用过 PrEP,且为男男性行为者 (MSM)。进行了反思性主题分析。 结果 共有 32 个访谈被纳入分析。主题包括以下内容:(1) COVID-19 期间 PrEP 的使用,(2) COVID-19 限制后性行为和关系的变化,(3) COVID-19 大流行期间 NHS 提供的服务,以及 (4) 大流行的更广泛背景影响。参与者报告了 PrEP 使用情况的变化(暂停或改用基于事件的 PrEP)。参与者报告说,去诊所就诊和预约就诊的机会减少了。对改用基于事件的 PrEP 的支持各不相同。社会隔离导致了对封锁规则的不同反应,尤其是在后来的封锁中。 结论 本研究从患者的角度探讨了 COVID-19 大流行给 PrEP 的使用和获取带来的挑战。研究还深入探讨了在个人情况发生变化时使用 PrEP 所需要的更广泛的支持。随着 PrEP 服务扩展到更广泛的社区,能够适应患者需求的灵活的 PrEP 服务模式将变得至关重要。 患者和公众的贡献 DO-PrEP 和 UPrEP 研究在设计研究主题指南时都听取了不同利益相关者的意见;这些利益相关者包括非专业公众成员、PrEP 使用者、PrEP 提供者以及参与艾滋病宣传和政策制定的个人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HIV Pre-Exposure Prophylaxis (PrEP) Users' Experiences of PrEP Access, Sexual Behaviour, and Well-Being During the COVID-19 Pandemic: A Welsh Qualitative Study

Background

HIV Pre-Exposure Prophylaxis (PrEP) has been available in Wales since 2017. The coronavirus disease (COVID-19) pandemic impacted UK sexual health services, leading to a reduction in service provision. There is a lack of research on the experiences of PrEP users during this time.

Objective

We aimed to explore the experiences of PrEP users in Wales following the introduction of COVID-19 pandemic measures.

Methods

We conducted a secondary data analysis of two prior interview studies (DO-PrEP and UPrEP). Data collection was undertaken between May 2020 and February 2021 using remote interviewing. Semi-structured interviews were conducted. Participants were ≥18 years of age, residents of Wales, current or previous PrEP users, and men who have sex with men (MSM). Reflexive thematic analysis was conducted.

Results

A total of 32 interviews were included in the analysis. Themes include the following: (1) PrEP use during COVID-19, (2) sexual behaviour and relationship changes following COVID-19 restrictions, (3) NHS service provision during the COVID-19 pandemic, and (4) wider contextual effects of the pandemic. Participants reported a change in PrEP use (pausing or switching to event-based PrEP). Participants reported reduced access to clinics and appointments. Support for changing to event-based PrEP was varied. Social isolation resulted in varied responses to lockdown rules, especially in later lockdowns.

Conclusion

This study provides patient perspectives on the challenges the COVID-19 pandemic posed to PrEP use and access. It offers insights into the broader support needs around PrEP use when an individual's circumstances change. Flexible models of PrEP provision, which can be adapted to the patient's needs, will be essential as PrEP delivery extends into the wider community.

Patient and Public Contribution

Both the DO-PrEP and UPrEP studies received input from various stakeholders in the design of the topic guides for the study; these included public lay members, PrEP users, PrEP providers, and individuals involved with HIV advocacy and policy.

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来源期刊
Health Expectations
Health Expectations 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.20
自引率
9.40%
发文量
251
审稿时长
>12 weeks
期刊介绍: Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.
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