Factores asociados a aceptación de profilaxis preexposición al VIH en hombres que tienen sexo con hombres de Panamá
[Factors associated with acceptance of HIV pre-exposure prophylaxis in men who have sex with men in Panamá]Carlos Chávez Sáenz1 , Joel Méndez Giraldo2
1. Universidad Americana, Panamá, Rep de Panamá; 2. Universidad de Panamá, Panamá, Rep de Panamá;
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Resumen
Introducción: La profilaxis preexposición al VIH (PrEP) es una estrategia de prevención primaria que consiste en la administración de dos antirretrovirales combinados que han demostrado una alta efectividad para reducir el riesgo de transmisión del VIH principalmente en poblaciones claves. Materiales y método: Se realizó un estudio observacional con la aplicación de un cuestionario autodirigido sobre aspectos sociodemográficos, comportamientos sexuales y la Escala Anticipada de Estigma a la PrEP a hombres que tenían sexo con hombres (HSH) que acudían a servicios de prevención del VIH en una organización comunitaria de Panamá. Se midió la proporción de aceptabilidad a la PrEP, características sociodemográficas, conductas sexuales y el estigma asociado a PrEP. Se utilizaron pruebas de significancia estadística según el tipo de variable que se asoció a la aceptación de PrEP. Se realizó un análisis bivariado utilizando el estadístico odds ratio para medir la fuerza de asociación entre diferentes factores con la aceptación a la PrEP. Resultados: Se encontró una aceptabilidad de PrEP de 53.9%, un bajo estigma anticipado asociado a la profilaxis y factores como la edad, educación, nacionalidad y frecuencia en el uso del condón asociados a la aceptabilidad de PrEP. Conclusiones: La aceptabilidad de PrEP es similar a las estimaciones mundiales y regionales. Un bajo estigma anticipado asociado a la PrEP permitirá hacer proyecciones sobre la implementación de esta estrategia. Además, se identificaron factores relacionados a la aceptabilidad como la edad, educación, nacionalidad y frecuencia en el uso de condones que coincidieron con otros estudios realizados a nivel mundial.
Abstract
Introduction: Pre-exposure prophylaxis for HIV (PrEP) is a primary prevention strategy that involves the administration of two combined antiretrovirals that have shown high effectiveness in reducing the risk of HIV transmission, mainly in key populations. Materials and methods: An observational study was conducted using a self-administered questionnaire on sociodemographic aspects, sexual behaviors, and the Pre-PrEP Stigma Scale with men who have sex with men (MSM) attending HIV prevention services at a community organization in Panama. The proportion of PrEP acceptability, sociodemographic characteristics, sexual behaviors, and stigma associated with PrEP were measured. Statistical significance tests were used according to the type of variable associated with PrEP acceptance. A bivariate analysis was performed using the odds ratio statistic to measure the strength of association between different factors and PrEP acceptance. Results: PrEP acceptability was found to be 53.9%, with low anticipated stigma associated with prophylaxis and factors such as age, education, nationality, and condom use frequency associated with PrEP acceptability. Conclusions: PrEP acceptability is similar to global and regional estimates. Low anticipated stigma associated with PrEP will allow projections to be made regarding the implementation of this strategy. Additionally, factors related to acceptability such as age, education, nationality, and condom use frequency were identified, coinciding with other studies conducted worldwide.
Citas
[1] Hillis A, Germain J, Hope V, et al. Pre - exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men (MSM): A Scoping Review on PrEP Service Delivery and Programming. AIDS Behav. 2020;24 (11):3056 - 3070. https://doi.org/10.1007/s10461 - 020 - 0.855 - 9
[2] Eakle R., Venter F, Rees, H. Pre - exposure prophylaxis (PrEP) in an era of stalled HIV prevention: Can it change the game? Retrovirology. 2018;15 (29):1 - 10. https://doi.org/10.1186/s12977 - 018 - 0408 - 3
[3] Joint United Nations Program on HIV/AIDS (UNAIDS). HIV Prevention: from crisis to opportunity. [internet] 2024 [citado 2024 May 4]. Disponible en : https://www.unaids.org/sites/default/files/media_asset/2023 - global - hiv - prevention - coalition - scorecards - key - findings_en.pdf
[4] Baeten JM, Donnell D, Ndase P, et al. PrEP Study Team (2012). Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. NEJM. 2012;367 (5): 399 - 410. https://doi.org/10.1056/NEJMoa1108524
[5] Peng P, Su,S, Fairley C, et al. A Global Estimate of the Acceptability of Pre - exposure Prophylaxis for HIV Among Men Who have Sex with Men: A Systematic Review and Meta - analysis. AIDS and behavior. 2018;22 (4):1063 - 1074. https://doi.org/10.1007/s10461 - 017 - 1675 - z
[6] Ogunbajo A, Leblanc NM, Kushwaha S, et al. Knowledge and Acceptability of HIV pre - exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Ghana. AIDS care. 2020;32 (3):330 - 336. https://doi.org/10.1080/09540121.2019.1675858
[7] Okeke NL, McLaurin T, Gilliam - Phillips R, et al. Awareness and acceptability of HIV pre - exposure prophylaxis (PrEP) among students at two historically Black universities (HBCU): a cross - sectional survey. BMC Public Health. 2021;21 (943):1 - 9. https://doi.org/10.1186/s12889 - 021 - 1,996 - 2
[8] Pimenta MC, Bermúdez XP, Godoi A, et al. Barreiras e facilitadores do acesso de populações vulneráveis çà PrEP no Brasil: Estudo ImPrEP Stakeholders [Barriers and facilitators for access to PrEP by vulnerable populations in Brazil: the ImPrEP Stakeholders Study]. Cadernos de saude publica. 2022; 38 (1), e00290620. https://doi.org/10.1590/0102 - 311X00290620
[9] Sun Z, Qianfei G, Dai Y, et al. Increasing awareness of HIV pre - exposure prophylaxis (PrEP) and willingness to use HIV PrEP among men who have sex with men: a systematic review and meta - analysis of global data. J Int AIDS Soc. 2022; 25 (3): e25883 https://doi.org/10.1002/jia2.25883
[10] Constanza A, Stuardo V. Aceptabilidad a usar profilaxis pre - exposición para VIH en hombres gay y otros hombres que tienen sexo con hombres: indagación en LAMIS 2018 Chile. Rev. Chil. Infectol. 2021;38 (5): 655 - 666. URL: https://www.revinf.cl/index.php/revinf/article/view/1124/671
[11] She B, Lu F, Zhao R, et al. Examining the effects of PrEP use on sexual behaviors and sexually transmitted infections among Chinese men who have sex with men: a cross - sectional study. AIDS Behav. 2024; 28 (9):3128 - 3138. https://doi.org/10.1007/s10461 - 024 - 0.398 - 9
[12] Sarang J, Sohn A. Awareness, intention to use Pre - Exposure prophylaxis and factors associated with awareness among men who have sex with men in the Republic of Korea. Trop Med Infect Dis. 2024; 9 (8): 170. https://doi.org/10.3390/tropicalmed9080170
[13] Brooks R, Landrian A, et al. Predictors of awareness, accessibility and acceptability of pre - exposure prophylaxis (PrEP) among English and Spanish speaking latino men who have sex with men in Los Angeles, California. J Immigr Minor Health. 2020; 22 (4): 708 - 716. https://doi.org/10.1007/s10903 - 019 - 0.955 - w
[14] Green K, Hoang L, Thi H, et al. Prepped for PreP? Acceptability, continuation and adherence among men who have sex with men and transgender women enrolled as part of Vietnam's first pre - exposure prophylaxis program. Sex Health. 2021; 18 (1): 104 - 115. https://doi.org/10.1071/SH20167
[15] Draper B, Min Z, Win Z, et al. Willingness to use HIV pre - exposure prophylaxis among gay men, other men who have sex with men and transgender women in Myanmar. J Int AIDS Soc. 2017; 20 (1): 21885. https://doi.org/10.7448/IAS.20.1.21885
[16] Van der Elst EM, Mbogua J, Operario D, et al. High acceptability of HIV pre - exposure prophylaxis but challenges in adherence and use: qualitative insights from a phase I trial of intermittent and daily PrEP in at - risk populations in Kenya. AIDS and behavior. 2013;17 (6): 2162 - 2172. https://doi.org/10.1007/s10461 - 012 - 0317 - 8
[17] Wheelock A, Eisingerich AB, Ananworanich J, et al. Are Thai MSM willing to take PrEP for HIV prevention? An analysis of attitudes, preferences and acceptance. PloS one. 2013;8 (1): e54288. URL: https://doi.org/10.1371/journal.pone.0054288
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