PDF(Pubmed)
Abstract：
BACKGROUND: In the U.S. there are significant racial and gender disparities in the uptake of pre-exposure prophylaxis (PrEP). Black Americans represented 14% of PrEP users in 2022, but accounted for 42% of new HIV diagnoses in 2021 and in the South, Black people represented 48% of new HIV diagnoses in 2021 but only 21% of PrEP users in 2022. Women who use drugs may be even less likely than women who do not use drugs have initiated PrEP. Moreover, women involved in community supervision programs (CSP) are less likely to initiate or use PrEP, More PrEP interventions that focus on Black women with recent history of drug use in CSPs are needed to reduce inequities in PrEP uptake.
METHODS: We conducted a secondary analysis from a randomized clinical trial with a sub-sample (n = 336) of the total (N = 352) participants from the parent study (E-WORTH), who tested HIV negative at baseline were considered PrEP-eligible. Black women were recruited from CSPs in New York City (NYC), with recent substance use. Participants were randomized to either E-WORTH (n = 172) an HIV testing plus, receive a 5-session, culturally-tailored, group-based HIV prevention intervention, versus an HIV testing control group (n = 180). The 5 sessions included an introduction to PrEP and access. This paper reports outcomes on improved awareness of PrEP, willingness to use PrEP, and PrEP uptake over the 12-month follow-up period. HIV outcomes are reported in a previous paper.
RESULTS: Compared to control participants, participants in this study assigned to E-WORTH had significantly greater odds of being aware of PrEP as a biomedical HIV prevention strategy (OR = 3.25, 95% CI = 1.64-6.46, p = 0.001), and indicated a greater willingness to use PrEP as an HIV prevention method (b = 0.19, 95% CI = 0.06-0.32, p = 0.004) over the entire 12-month follow-up period.
CONCLUSIONS: These findings underscore the effectiveness of a culturally-tailored intervention for Black women in CSP settings in increasing awareness, and intention to initiate PrEP. Low uptake of PrEP in both arms highlight the need for providing more robust PrEP-on-demand strategies that are integrated into other services such as substance abuse treatment.
BACKGROUND: ClinicalTrials.gov Identifier: NCT02391233 .
METHODS: We conducted a secondary analysis from a randomized clinical trial with a sub-sample (n = 336) of the total (N = 352) participants from the parent study (E-WORTH), who tested HIV negative at baseline were considered PrEP-eligible. Black women were recruited from CSPs in New York City (NYC), with recent substance use. Participants were randomized to either E-WORTH (n = 172) an HIV testing plus, receive a 5-session, culturally-tailored, group-based HIV prevention intervention, versus an HIV testing control group (n = 180). The 5 sessions included an introduction to PrEP and access. This paper reports outcomes on improved awareness of PrEP, willingness to use PrEP, and PrEP uptake over the 12-month follow-up period. HIV outcomes are reported in a previous paper.
RESULTS: Compared to control participants, participants in this study assigned to E-WORTH had significantly greater odds of being aware of PrEP as a biomedical HIV prevention strategy (OR = 3.25, 95% CI = 1.64-6.46, p = 0.001), and indicated a greater willingness to use PrEP as an HIV prevention method (b = 0.19, 95% CI = 0.06-0.32, p = 0.004) over the entire 12-month follow-up period.
CONCLUSIONS: These findings underscore the effectiveness of a culturally-tailored intervention for Black women in CSP settings in increasing awareness, and intention to initiate PrEP. Low uptake of PrEP in both arms highlight the need for providing more robust PrEP-on-demand strategies that are integrated into other services such as substance abuse treatment.
BACKGROUND: ClinicalTrials.gov Identifier: NCT02391233 .
摘要：
背景：在美国，暴露前预防（PrEP）的使用存在显著的种族和性别差异。2022年，美国黑人占PrEP用户的14%，但在2021年和南方，黑人占新艾滋病毒诊断的42%。在2021年，黑人占新的艾滋病毒诊断的48％，但在2022年，只有21％的PrEP用户。使用药物的女性可能比不使用药物的女性发起PrEP的可能性更小。此外，参与社区监督计划（CSP）的妇女不太可能发起或使用PrEP，需要更多的PrEP干预措施，重点是最近在CSP中使用药物的黑人妇女，以减少PrEP摄取的不平等。
方法：我们从一项随机临床试验中进行了二次分析，对来自母体研究（E-WORTH）的全部（N=352）参与者进行了子样本（n=336）。基线时HIV检测阴性的患者被认为符合PrEP标准.黑人妇女是从纽约市（NYC）的CSP招募的，最近的物质使用。参与者被随机分配到E-WORTH（n=172）和HIV检测加，收到5个会议，文化定制，以小组为基础的艾滋病毒预防干预，与HIV检测对照组相比（n=180）。这5场会议包括对PrEP和访问的介绍。本文报告了提高PrEP意识的结果，愿意使用PrEP，和PrEP摄取在12个月的随访期间。在以前的一篇论文中报道了艾滋病毒的结果。
结果：与对照参与者相比，这项研究中被分配到E-WORTH的参与者意识到PrEP作为一种生物医学HIV预防策略的可能性明显更大（OR=3.25，95％CI=1.64-6.46，p=0.001），并且表明在整个12个月的随访期内，使用PrEP作为HIV预防方法的意愿更大（b=0.19，95％CI=0.06-0.32，p=0.004）。
结论：这些发现强调了在CSP环境中对黑人妇女进行文化定制干预的有效性，并打算启动PrEP。这两个部门对PrEP的吸收都很低，这突出表明需要提供更强有力的按需PrEP战略，将其纳入药物滥用治疗等其他服务。
背景：ClinicalTrials.gov标识符：NCT02391233。
方法：我们从一项随机临床试验中进行了二次分析，对来自母体研究（E-WORTH）的全部（N=352）参与者进行了子样本（n=336）。基线时HIV检测阴性的患者被认为符合PrEP标准.黑人妇女是从纽约市（NYC）的CSP招募的，最近的物质使用。参与者被随机分配到E-WORTH（n=172）和HIV检测加，收到5个会议，文化定制，以小组为基础的艾滋病毒预防干预，与HIV检测对照组相比（n=180）。这5场会议包括对PrEP和访问的介绍。本文报告了提高PrEP意识的结果，愿意使用PrEP，和PrEP摄取在12个月的随访期间。在以前的一篇论文中报道了艾滋病毒的结果。
结果：与对照参与者相比，这项研究中被分配到E-WORTH的参与者意识到PrEP作为一种生物医学HIV预防策略的可能性明显更大（OR=3.25，95％CI=1.64-6.46，p=0.001），并且表明在整个12个月的随访期内，使用PrEP作为HIV预防方法的意愿更大（b=0.19，95％CI=0.06-0.32，p=0.004）。
结论：这些发现强调了在CSP环境中对黑人妇女进行文化定制干预的有效性，并打算启动PrEP。这两个部门对PrEP的吸收都很低，这突出表明需要提供更强有力的按需PrEP战略，将其纳入药物滥用治疗等其他服务。
背景：ClinicalTrials.gov标识符：NCT02391233。
