Predicting PrEP acceptability and self‐efficacy among men who have sex with men in the UK: The roles of identity resilience, science mistrust, and stigma
Notice bibliographique
Résumé
INTRODUCTION: Pre-exposure prophylaxis (PrEP) is medication used to prevent the spread of HIV. Populations with increased need of HIV prevention (e.g., men who have sex with men [MSM]) are eligible for free PrEP in the UK. However, HIV surveillance reports indicate stagnated uptake of the drug, alongside increasing rates of HIV acquisition. As such, psychosocial research is needed to explore the social barriers to PrEP uptake. This study aimed to explore the role of identity resilience (i.e., ability to maintain a positive and stable sense of self) as a predictor for PrEP usage. We hypothesized that PrEP self-efficacy (i.e., belief in one's ability to take PrEP) would be positively predicted by PrEP acceptability. We also hypothesized that identity worth and identity continuity (components of identity resilience) would be associated with PrEP acceptability and PrEP self-efficacy. These would be mediated by mistrust in science, PrEP stigma, and perceived risk of HIV. METHODS: In total, 500 MSM who were assigned male at birth, were aged ≥18 years, and did not have HIV participated in an online cross-sectional, psychometric study between June and September 2023. Participants had to be based in the UK but could either be PrEP users or non-users. Structural equation modelling was used to explore a model of best fit to test the hypotheses. RESULTS: = 4.51, degrees of freedom = 3, p-value = 0.209, comparative fit index 0.997, Tucker Lewis Index 0.972, root mean square of approximation 0.032, and standardized root mean square residual 0.011. Identity worth was positively associated with PrEP self-efficacy. Identity worth was indirectly associated with PrEP acceptability and PrEP self-efficacy. The positive association of identity worth and PrEP acceptability was mediated through lower mistrust of science and lower PrEP stigma but not perceived risk of HIV. CONCLUSIONS: Results indicate that the decision to take PrEP is associated with the constructs of identity worth (i.e., self-esteem, self-efficacy, and distinctiveness) rather than risk-based appraisals alone. The reasons for accessing and using PrEP may no longer be motivated by an inherent perceived risk of HIV acquisition. When trying to increase PrEP uptake, addressing specific parts of identity resilience may be beneficial. For example, therapeutic interventions (e.g., counselling) could include interventions to improve positive sexual identities and self-esteem.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,003 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».