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Willingness to use PrEP among female university students in Lesotho.
PLOS ONE ( IF 3.7 ) Pub Date : 2020-03-31 , DOI: 10.1371/journal.pone.0230565
Dimitris Karletsos 1 , Charlotte R Greenbaum 2 , Emily Kobayashi 3 , Margaret McConnell 2
Affiliation  

Oral pre-exposure prophylaxis (PrEP) for HIV-negative individuals at high risk was introduced in Lesotho in April 2016. To assess the feasibility and acceptability of PrEP in Lesotho and to study the attitudes and beliefs around HIV risk and prevention measures among young women, between September and December 2016 we asked 302 female university students at fourteen higher education institutions in Lesotho about their sexual behavior, experiences of sexual coercion and abuse, HIV risk perception, willingness to use PrEP, as well as their attitudes toward condom use and self-administration of daily medications. Overall, 57.3% of the sample reported perceiving themselves at risk of acquiring HIV and 32.1% reported being strongly willing to use PrEP if it were available in their community. In a multivariate mediation analysis, perceived HIV risk was associated with 11.5 percentage points increase in likelihood of using PrEP (p = 0.041). Multiple concurrent sexual partnership was associated with 16.1 percentage points increase in likelihood of self-perceived HIV risk (p = 0.007), while having sexual partners in polygamous relationships was associated with 17.8 percentage points increase in likelihood of self-perceived HIV risk (p = 0.002) and the mediated indirect effect accounted for 18.2% of its total effect. Those who reported strong adherence to antibiotics were 23.1 percentage points more likely to express willingness to use PrEP than those who did not (p = 0.004), and those who reported to dislike condoms were 19.1 percentage points more likely to be willing to use PrEP than those who did not report aversion to condom use: these effect were direct and not mediated by HIV risk perception. Intimate partner violence (IPV) in the network of peers was also directly associated with willingness to use PrEP and its effect was not significantly mediated by HIV risk perception: those who had friends who experienced intimate partner violence were 14.9 percentage points more likely to be willing to use PrEP than those who did not report IPV in their network of peers (p = 0.009). These findings support the inclusion of individuals with multiple concurrent sexual partners among the key populations for PrEP provision and confirm that willingness to use PrEP is not solely driven by HIV risk perception. They also indicate that the presence of IPV in peer networks is related to one’s willingness to use PrEP. PrEP service provision may generate synergies with IPV prevention programs when offered within this framework.



中文翻译:

莱索托女大学生愿意使用PrEP的意愿。

2016年4月,在莱索托对高危HIV阴性人群进行了口服暴露前预防(PrEP)。评估了PrEP在莱索托的可行性和可接受性,并研究了年轻女性对HIV风险和预防措施的态度和信念。在2016年9月至2016年12月期间,我们向莱索托的14个高等教育机构的302名女大学生询问了他们的性行为,性强迫和性虐待的经历,艾滋病毒的风险感知,使用PrEP的意愿以及他们对使用安全套和自我的态度-每日药物的管理。总体而言,有57.3%的样本表示自己有感染艾滋病毒的风险,而32.1%的样本表示强烈愿意使用PrEP(如果在社区中可以使用)。在多元中介分析中,感染艾滋病毒的风险与使用PrEP的可能性增加11.5个百分点相关(p = 0.041)。多重并发性伴侣关系使自我感觉到的HIV风险的可能性增加16.1个百分点(p = 0.007),而具有一夫多妻关系的性伴侣会使自我感觉到的HIV风险的可能性增加17.8个百分点(p = 0.002),介导的间接效应占其总效应的18.2%。那些对抗生素有强烈依从性的人比不愿意的人表示愿意使用PrEP的可能性高23.1个百分点(p = 0.004),而那些不喜欢避孕套的人表示愿意使用PrEP的可能性比不使用安全套的人高19.1个百分点。那些没有报告对安全套有反感的人使用:这些影响是直接的,而不是由HIV风险感知介导的。在同龄人网络中的亲密伴侣暴力(IPV)也与使用PrEP的意愿直接相关,其影响并没有明显受到HIV风险感知的调节:那些有亲朋好友经历亲密伴侣暴力行为的朋友,其愿意意愿的可能性要高14.9个百分点与未在其对等网络中报告IPV的人相比,使用PrEP(p = 0.009)。这些发现支持在关键人群中纳入具有多个并发性伴侣的个人以提供PrEP,并证实使用PrEP的意愿并非仅由HIV风险感知驱动。它们还表明,对等网络中IPV的存在与使用PrEP的意愿有关。

更新日期:2020-03-31
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