Use of pre-exposure prophylaxis for HIV among gay and other men who have sex with men
Uso de profilaxis previa a la exposición al VIH por hombres homosexuales y hombres que tienen relaciones sexuales con hombres
Uso da profilaxia pré-exposição ao HIV por gays e homens que fazem sexo com homens
Paulo Victor Avelino Monteiro; Andressa Carneiro Moreira; Stéfanie Helen da Silva Santos; Jamile Calmon dos Santos; Mayara Nascimento de Vasconcelos; Monalisa Rodrigues da Cruz; George Jó Bezerra Sousa; Karla Corrêa Lima Miranda; Maria Lúcia Duarte Pereira
Abstract
Objective: To estimate the prevalence and factors associated with adherence to and discontinuation of pre-exposure prophylaxis (PrEP) for HIV among gay and other men who have sex with men (MSM). Methods: This is a cross-sectional epidemiological study. Outcomes analyzed were adherence to and discontinuation of PrEP use.
Results: The prevalence of PrEP adherence was 73.3%, while discontinuation reached 19.0%. Adherence was associated with factors such as missed medical appointments and diagnoses of sexually transmitted infections (STIs). Discontinuation, on the other hand, was linked to race, missed medical appointments, periods of non-use, switching health care providers, and tobacco use. Conclusion and implications for practice: Adherence was the most prevalent outcome in PrEP use among gay and other MSM. Both adherence and discontinuation were influenced by social, cultural, economic, racial/ethnic, and psychological factors. Identifying these associations may help improve the implementation of health policies, monitor PrEP usage, and strengthen the Brazilian Unified Health System (SUS).
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Objetivo: Estimar a prevalência e os fatores associados à adesão e à descontinuidade da profilaxia pré-exposição (PrEP) ao HIV por gays e homens que fazem sexo com homens (HSH). Método: Este é um estudo epidemiológico transversal. Os desfechos analisados foram a adesão e a descontinuidade do uso da PrEP.
Resultados: A prevalência de adesão ao uso da PrEP foi de 73,3%, enquanto a descontinuidade atingiu 19,0%. A adesão mostrou associação com fatores como faltas às consultas e diagnóstico de infecções sexualmente transmissíveis (ISTs). Já a descontinuidade esteve associada à raça, faltas às consultas, períodos de interrupção no uso, troca de serviço de saúde e consumo de fumo/tabaco. Conclusão e implicações para a prática: A adesão foi o desfecho mais prevalente entre gays e HSH no uso da PrEP. Tanto a adesão quanto a descontinuidade demonstraram relação com fatores sociais, culturais, econômicos, étnico-raciais e psicológicos. Identificar essas associações pode ser útil para aprimorar a implementação de políticas de saúde, monitorar o uso da PrEP e fortalecer o Sistema Único de Saúde (SUS).
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Referências
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Submetido em:
06/10/2024
Aceito em:
03/12/2024
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