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IF 2.9 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-03-19 DOI:10.17269/s41997-025-01009-5

Wale Ajiboye, Wangari Tharao, Maureen Owino, Lena Soje, Jason M Lo Hog Tian, Amy Ly, Margaret Kisikaw Piyesis, Albert McLeod, Mathew Fleury, Kristin McBain, Notisha Massaquoi, Tegan Mosugu, Jaris Swidrovich, Darrell H S Tan, LaRon Nelson, Sean B Rourke

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引用次数: 0

摘要

目标：加拿大的黑人和土著男性在新的 HIV 感染中仍然承受着巨大且不成比例的负担。本研究旨在了解加拿大白人、黑人和土著男性对 PrEP 的认识和使用情况以及 PrEP 级联的种族差异，从而为我们由政府资助的医疗保健系统立即采取行动提供证据：我们对 2021 年 6 月启动的 "我准备好了"（I'm Ready）全国 HIV 自我检测研究项目的横截面数据（n = 4294）进行了二次分析，该项目将持续到 2023 年 12 月。我们使用二元逻辑回归评估了 PrEP 意识和接受率的种族差异。结果显示，黑人参与者（OR = 0.34）、女性参与者（OR = 0.34）、男性参与者（OR = 0.34）、女性参与者（OR = 0.34）、男性参与者（OR = 0.34）：黑人参与者（OR = 0.34，CI 0.29，0.39）、男男性行为者（OR = 0.27，CI 0.21，0.35）、18-45 岁（OR = 0.35，CI 0.30，0.40）、居住在城市（OR = 0.41，CI 0.33，0.51）或农村地区（OR = 0.33，CI 0.26，0.44），并且符合 PrEP 资格（OR = 0.34，CI 0.28，0.40）的人比白人参与者更不可能了解 PrEP。原住民参与者（OR = 0.57，CI 0.44，0.75）、年龄在 18-45 岁之间（OR = 0.57，CI 0.43，0.75）、居住在农村社区（OR = 0.15，CI 0.25，0.57）以及符合 PrEP 资格者（OR = 0.62，CI 0.46，0.83）了解 PrEP 的可能性低于白人参与者。在 PrEP 的采取方面，年龄在 18-45 岁（OR = 0.59，CI 0.44，0.80）、居住在农村社区（OR = 0.44，CI 0.23，0.84）、符合 PrEP 资格（OR = 0.62，CI 0.46，0.85）的黑人参与者采取 PrEP 的可能性低于白人参与者。此外，居住在城市地区的原住民男性比白人参与者更有可能接受 PrEP 治疗（OR = 1.65，CI 1.01，2.69）：结论：需要立即采取基于社区和公共卫生的干预措施，以提高加拿大黑人和土著社区对 PrEP 的认识、获取和使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Racial disparities in HIV pre-exposure prophylaxis (PrEP) awareness and uptake among white, Black, and Indigenous men in Canada: Analysis of data from the I'm Ready national HIV self-testing study.

Objectives: Black and Indigenous men in Canada continue to experience significant and disproportionate burden of new HIV infection. The purpose of this study was to understand racial differences in PrEP awareness and use, and PrEP cascade among white, Black, and Indigenous men in Canada with the intention to provide evidence for immediate action in our publicly funded health care system.

Methods: We performed a secondary analysis (n = 4294) of cross-sectional data from the I'm Ready national HIV self-testing research program launched in June 2021 and running through December 2023. Binary logistic regression was used to assess racial differences in PrEP awareness and uptake. A proposed PrEP cascade was developed using the data on awareness, uptake, and retention in PrEP care.

Results: Black participants (OR = 0.34, CI 0.29, 0.39), who are gbMSM (OR = 0.27, CI 0.21, 0.35), aged 18-45 (OR = 0.35, CI 0.30, 0.40), living in urban (OR = 0.41, CI 0.33, 0.51) or rural areas (OR = 0.33, CI 0.26, 0.44), and who are PrEP-eligible (OR = 0.34, CI 0.28, 0.40), were less likely to be aware of PrEP than white participants. Indigenous participants (OR = 0.57, CI 0.44, 0.75), aged 18-45 (OR = 0.57, CI 0.43, 0.75), living in rural communities (OR = 0.15, CI 0.25, 0.57), and who are PrEP-eligible (OR = 0.62, CI 0.46, 0.83), were less likely to be aware of PrEP than white participants. For PrEP uptake, Black participants (OR = 0.61, CI 0.46, 0.82), aged 18-45 (OR = 0.59, CI 0.44, 0.80), living in rural communities (OR = 0.44, CI 0.23, 0.84), and PrEP-eligible (OR = 0.62, CI 0.46, 0.85), were less likely to be on PrEP than white participants. Also, Indigenous men living in urban areas were more likely to be on PrEP than white participants (OR = 1.65, CI 1.01, 2.69).

Conclusion: Community-based and public health interventions are immediately needed to increase PrEP awareness, access, and uptake for Black and Indigenous communities in Canada.

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来源期刊

Canadian Journal of Public Health-Revue Canadienne De Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.10

自引率

4.70%

发文量

128

期刊介绍： The Canadian Journal of Public Health is dedicated to fostering excellence in public health research, scholarship, policy and practice. The aim of the Journal is to advance public health research and practice in Canada and around the world, thus contributing to the improvement of the health of populations and the reduction of health inequalities. CJPH publishes original research and scholarly articles submitted in either English or French that are relevant to population and public health. CJPH is an independent, peer-reviewed journal owned by the Canadian Public Health Association and published by Springer. Énoncé de mission La Revue canadienne de santé publique se consacre à promouvoir l’excellence dans la recherche, les travaux d’érudition, les politiques et les pratiques de santé publique. Son but est de faire progresser la recherche et les pratiques de santé publique au Canada et dans le monde, contribuant ainsi à l’amélioration de la santé des populations et à la réduction des inégalités de santé. La RCSP publie des articles savants et des travaux inédits, soumis en anglais ou en français, qui sont d’intérêt pour la santé publique et des populations. La RCSP est une revue indépendante avec comité de lecture, propriété de l’Association canadienne de santé publique et publiée par Springer.