ABSTRACT

Pre-exposure prophylaxis (PrEP) is an effective form of Human Immunodeficiency Virus (HIV) prevention for people at potential risk for exposure. Despite its demonstrated efficacy, PrEP uptake and adherence have been discouraging, especially among groups most vulnerable to HIV transmission. A primary message to persons who are at elevated risk for HIV has been to focus on risk reduction, sexual risk behaviors, and continued condom use, rarely capitalizing on the positive impact on sexuality, intimacy, and relationships that PrEP affords. This systematic review synthesizes the findings and themes from 16 quantitative, qualitative, and mixed methods studies examining PrEP motivations and outcomes focused on sexual satisfaction, sexual pleasure, sexual quality, and sexual intimacy. Significant themes emerged around PrEP as increasing emotional intimacy, closeness, and connectedness; PrEP as increasing sexual options and opportunities; PrEP as removing barriers to physical closeness and physical pleasure; and PrEP as reducing sexual anxiety and fears. It is argued that positive sexual pleasure motivations should be integrated into messaging to encourage PrEP uptake and adherence, as well as to destigmatize sexual pleasure and sexual activities of MSM.

摘要

暴露前预防 (PrEP) 是人类免疫缺陷病毒 (HIV) 预防的一种有效形式，适用于有潜在暴露风险的人。尽管其已证明有效，但 PrEP 的吸收和依从性一直令人沮丧，尤其是在最容易感染 HIV 的人群中。对 HIV 高危人群的主要信息是关注降低风险、性风险行为和继续使用安全套，很少利用 PrEP 对性、亲密关系和人际关系的积极影响。这篇系统综述综合了 16 项定量、定性和混合方法研究的结果和主题，这些研究检查了 PrEP 的动机和结果，重点是性满意度、性快感、性质量和性亲密。围绕 PrEP 出现的重要主题是增加情感亲密、亲密和联系；PrEP 作为增加性选择和机会；PrEP 作为消除身体亲密和身体愉悦的障碍；和 PrEP 可以减少性焦虑和恐惧。有人认为，应该将积极的性快感动机整合到信息中，以鼓励 PrEP 的吸收和坚持，以及消除 MSM 的性快感和性活动的污名。