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Ma EC, Rogers BG, Chan PA, Toma E, Almonte A, Napoleon S, Galipeau D, Ahluwalia JS, Murphy M. Characterizing Interest in and Uptake of Preexposure Prophylaxis for HIV Prevention Among Men in a US State Correctional System. Sex Transm Dis 2024; 51:162-170. [PMID: 38412463 PMCID: PMC10904015 DOI: 10.1097/olq.0000000000001912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND People experiencing incarceration are disproportionately impacted by HIV and are potential candidates for HIV preexposure prophylaxis (PrEP). We explored factors associated with PrEP interest and PrEP uptake and described barriers to PrEP uptake among incarcerated men in a state correctional system. METHODS From September 2019 to July 2022, incarcerated men at the Rhode Island Department of Corrections were screened for PrEP eligibility and referred to a PrEP initiation study. We used bivariate analyses and multivariable logistic regression models to explore factors associated with PrEP interest and uptake in the screening sample. RESULTS Of the men screened and determined to be eligible for PrEP, approximately half (50%) were interested in taking PrEP. Individuals identifying as men who have sex with men (adjusted odds ratio, 4.46; 95% confidence interval, 1.86-11.4) and having multiple female sex partners (adjusted odds ratio, 2.98; 95% confidence interval, 1.47-6.27) were more likely to express interest in PrEP (interested/not interested) than those not reporting these behavioral factors. Preexposure prophylaxis uptake (yes/no) was 38%. Lack of PrEP interest, low self-perceived risk of HIV acquisition, and unpredictable lengths of incarceration were the most frequently encountered barriers to PrEP uptake. CONCLUSIONS Men reporting sexual transmission behaviors were more interested in PrEP and had higher uptake than other men. Preexposure prophylaxis interest and HIV risk factors were both moderately high, which suggests that men experiencing incarceration should be screened for and offered PrEP as part of standard clinical care. Study findings have important implications for research and practice to adapt PrEP care to correctional systems.
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Affiliation(s)
- Emily C Ma
- From the Department of Behavioral and Social Sciences, Brown University School of Public Health
| | | | - Philip A Chan
- Division of General Internal Medicine, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Emily Toma
- Division of General Internal Medicine, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Alexi Almonte
- Division of Infectious Diseases, The Miriam Hospital
| | | | - Drew Galipeau
- Division of Infectious Diseases, The Miriam Hospital
| | - Jasjit S Ahluwalia
- From the Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Matthew Murphy
- Division of General Internal Medicine, the Warren Alpert Medical School of Brown University, Providence, RI
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de Sousa AFL, Lima SVMA, Ribeiro CJN, de Sousa AR, Barreto NMPV, Camargo ELS, Araújo AAC, dos Santos AD, Bezerra-Santos M, Fortunato MDR, Possani MA, dos Santos AJ, de Lima JLT, Gir E, Fronteira I, Mendes IAC. Adherence to Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in Portuguese-Speaking Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4881. [PMID: 36981792 PMCID: PMC10049571 DOI: 10.3390/ijerph20064881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Strengthening strategies to improve adherence to the use of pre-exposure prophylaxis (PrEP) in key populations constitutes a global health priority to be achieved across countries, especially in countries that share a high flow of people such as Brazil and Portugal. This study aimed to analyze the factors associated with adherence to PrEP among MSM from two Portuguese-speaking countries, highlighting the opportunities and preventive strategies for the global health scenario. This was a cross-sectional analytical online survey conducted from January 2020 to May 2021 with MSM in Brazil and Portugal. For analysis of the data, the Poisson regression model was used to estimate the prevalence ratio (PR) for developing a model to evaluate the associated factors in both countries in a comparative and isolated way. Adherence to PrEP use corresponded to 19.5% (n = 1682) of the overall sample: 18.3% (n = 970) for Brazil and 21.5% (n = 712) for Portugal. Having more than two sex partners in the last 30 days (aPR: 30.87) and routinely undergoing HIV tests (aPR: 26.21) increased the use of this medication. Being an immigrant (PR: 1.36) and knowing the partner's serological status (PR: 1.28) increased adherence to PrEP in Portugal, whereas, in Brazil, it was being an immigrant (PR: 0.83) and not knowing the serological status (PR: 2.24) that promoted the use of this medication. Our findings reinforce the need to invest in programs and strategies to improve access and adherence to PrEP, especially in key populations.
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Affiliation(s)
- Alvaro Francisco Lopes de Sousa
- Hospital Sírio-Libânes, Instituto de Ensino e Pesquisa, São Paulo 01308-050, São Paulo, Brazil
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal
| | - Shirley Veronica Melo Almeida Lima
- Collective Health Research Center, Universidade Federal de Sergipe, Lagarto 49400-000, Sergipe, Brazil
- Graduate Program in Nursing, Universidade Federal de Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | | | - Anderson Reis de Sousa
- Graduate Program in Nursing and Health of the Nursing School, Universidade Federal da Bahia, Salvador 40170-110, Bahia, Brazil
| | | | | | | | - Allan Dantas dos Santos
- Collective Health Research Center, Universidade Federal de Sergipe, Lagarto 49400-000, Sergipe, Brazil
| | - Márcio Bezerra-Santos
- Medical and Nursing Science Center, Universidade Federal de Alagoas, Arapiraca 57309-005, Alagoas, Brazil
| | | | - Matheus Arantes Possani
- Medical School, Universidade Federal do Triângulo Mineiro, Uberaba 38025-180, Minas Gerais, Brazil
| | - Adriano José dos Santos
- Collective Health Research Center, Universidade Federal de Sergipe, Lagarto 49400-000, Sergipe, Brazil
| | | | - Elucir Gir
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
| | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal
| | - Isabel Amélia Costa Mendes
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
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Liu H, Lai G, Shi G, Zhong X. The Influencing Factors of HIV-Preventive Behavior Based on Health Belief Model among HIV-Negative MSMs in Western China: A Structural Equation Modeling Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10185. [PMID: 36011822 PMCID: PMC9407807 DOI: 10.3390/ijerph191610185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/07/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: Men who have sex with other men (MSMs) are at high risk of being infected by the human immunodeficiency virus (HIV) in western China. Pre-exposure prophylaxis (PrEP) is an efficient way to prevent HIV transmission. However, adherence is the most vital determinant factor affecting PrEP effectiveness. We conducted a study based on the Health Belief Model to explore factors that predict adherence to PrEP among a cohort of 689 MSMs in western China. (2) Methods: We assessed perceived susceptibility, severity, benefits, barriers, self-efficacy, cues to action, and HIV-preventive behavior through a cross-sectional survey. (3) Results: PrEP self-efficacy was directly associated with PrEP behaviors (β = 0.221, p < 0.001), cues to action were directly associated with PrEP behaviors (β = 0.112, p < 0.001), perceived benefits were directly associated with PrEP behaviors (β = 0.101, p < 0.001), and perceived susceptibility was directly associated with PrEP behaviors (β = 0.117, p = 0.043). (4) Conclusion: Medication self-efficacy, perceived susceptibility, and cue to action structures are predictors of the MSMs’ HIV-preventive behavior in western China. These results will provide theoretical plans for promoting PrEP adherence in MSMs.
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