Các yếu tố đa cấp định hình nhận thức và thái độ về biện pháp dự phòng trước phơi nhiễm nhằm ngăn ngừa HIV trong nhóm phụ nữ có liên quan đến công lý hình sự

Archives of Sexual Behavior - Tập 50 - Trang 1743-1754 - 2020
Emily F. Dauria1, Andrew Levine2, Samantha V. Hill3, Marina Tolou-Shams1, Katerina Christopoulos4
1Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, USA
2Department of Sociology, New York University, New York, USA
3Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
4Department of Medicine, University of California San Francisco, San Francisco, USA

Tóm tắt

Mặc dù biện pháp dự phòng trước phơi nhiễm (PrEP) là một công cụ quan trọng trong nỗ lực ngăn ngừa HIV, nhưng còn rất ít thông tin về PrEP như một chiến lược phòng ngừa cho nhóm phụ nữ có liên quan đến công lý hình sự (CJI). Mục đích của nghiên cứu này là xem xét các yếu tố đa cấp ảnh hưởng đến sự nhận thức và chấp nhận PrEP ở phụ nữ CJI. Từ tháng 1 đến tháng 12 năm 2017, chúng tôi đã thực hiện 52 cuộc phỏng vấn với phụ nữ CJI có nguy cơ cao với HIV và các bên liên quan trong hệ thống công lý hình sự (CJ) và sức khỏe cộng đồng (PH). Các cuộc phỏng vấn đã khám phá mức độ nhận thức về PrEP và các yếu tố đa cấp ảnh hưởng đến sự chấp nhận PrEP. Dữ liệu đã được phân tích bằng phân tích chủ đề theo phương pháp quy nạp và tóm tắt điều hành. Phần mềm Atlas.ti đã hỗ trợ phân tích. Phần lớn phụ nữ CJI (n = 27) có độ tuổi trung bình là 41,3, đến từ các nhóm sắc tộc thiểu số (56% Da đen/Người Mỹ gốc Phi; 19% Latinx) và báo cáo tham gia vào hành vi nguy cơ cao gần đây (gần 60% đã tham gia vào tình dục trao đổi, 22% báo cáo có ≥ 4 đối tác tình dục, và 37% báo cáo sử dụng ma túy tiêm chích). Trong số các bên liên quan của hệ thống (n = 25), 52% đại diện cho lĩnh vực CJ. Mặc dù phụ nữ CJI thường không biết đến PrEP, nhưng thái độ đối với PrEP thì rất tích cực. Các rào cản trong việc chấp nhận PrEP bao gồm tác dụng phụ của thuốc (mức độ cá nhân); sự không tin tưởng vào các cơ chế ngăn ngừa HIV (mức độ cộng đồng); thiếu các nỗ lực ngăn ngừa HIV tại địa phương đối với phụ nữ có nguy cơ cao (mức độ chính sách công/giai đoạn dịch HIV). Các yếu tố thúc đẩy PrEP bao gồm rủi ro HIV cảm nhận được (mức độ cá nhân); PrEP là một phương pháp ngăn ngừa HIV mà phụ nữ có thể kiểm soát mà không cần thương lượng với bạn tình (mức độ mạng lưới xã hội và tình dục); và sự sẵn có của bảo hiểm y tế công cộng (mức độ cộng đồng). Mặc dù có sự nhận thức thấp về PrEP, phụ nữ CJI vẫn bày tỏ thái độ tích cực về PrEP. Để cải thiện tiếp cận PrEP cho phụ nữ CJI, các nỗ lực thực hiện nên giải quyết các rào cản và tận dụng các yếu tố thúc đẩy ở nhiều cấp độ để đạt hiệu quả tối đa.

Từ khóa

#PrEP #phòng ngừa HIV #phụ nữ liên quan đến công lý hình sự #nhận thức #chấp nhận

Tài liệu tham khảo

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