Introduction

Long Island has the largest suburban human immunodeficiency virus (HIV) epidemic in the USA with an estimated 5,730 people living with HIV/AIDS in 2018 (most recent data). While pre-exposure prophlaxis (PrEP) is a promising primary intervention strategy to reduce HIV incidence, the uptake of this biomedical prevention strategy has been very low. Factors such as homophobia, stigma, and discrimination against men who have sex with men (MSM) and transgender women still exist in the community through provider interactions, and negatively affect the well-being of these populations. The aim of this study was to examine PrEP knowledge, attitudes, and practices among MSM and transgender women on Long Island.

Methods

Fifteen interviews were conducted with MSM and transgender women; interviews were transcribed and analyzed using an inductive method involving constant comparison.

Results

Four main themes emerged from our analysis: (1) participants have high agency in accessing and utilizing HIV-related biomedical prevention services; (2) participants had limited understanding of what PrEP is and what it means to be on PrEP; (3) PrEP-user stigma and costs are the biggest barriers to initiating and remaining on PrEP; and (4) E-health, credible Internet-resources, and technology-based programming are needed to support current and potential PrEP users.

Conclusions

This study, the first study of PrEP attitudes in a suburban environment, highlights the need for evidence-based health promotion and sexual health interventions designed for suburban gender and sexual minorities that are evidence-based and go beyond goal setting and improving self-efficacy.

中文翻译：

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MSM和跨性别者在美国郊区最大的艾滋病流行中的PrEP态度

介绍

长岛是美国郊区最大的人类免疫缺陷病毒（HIV）流行病，2018年估计有5,730例HIV / AIDS感染者（最新数据）。尽管暴露前预后（PrEP）是减少艾滋病毒发生率的有希望的主要干预策略，但这种生物医学预防策略的吸收率非常低。同性恋恐惧症，耻辱感，歧视男男性接触者（MSM）和变性女性的因素仍然通过提供者互动在社区中存在，并对这些人群的福祉产生负面影响。这项研究的目的是检查长岛上的男男性接触者和变性妇女中的PrEP知识，态度和做法。

方法

对男男性接触者和变性妇女进行了十五次采访；采访被转录并使用归纳法进行分析，包括不断的比较。

结果

我们的分析提出了四个主要主题：（1）参与者在获得和利用与艾滋病有关的生物医学预防服务方面具有很高的权威；（2）参与者对PrEP是什么以及对PrEP意味着什么的理解有限；（3）PrEP用户的耻辱和成本是启动和保留PrEP的最大障碍；（4）需要电子卫生，可靠的互联网资源和基于技术的编程来支持当前和潜在的PrEP用户。

结论

这项研究是对郊区环境中PrEP态度的第一项研究，强调了针对基于证据的郊区性别和性少数群体的循证健康促进和性健康干预措施的必要性，这些措施不仅基于目标，而且还提高了自我效能。