Characterizing Cis and Trans Women’s HIV Risk and Access to HIV Prophylaxis in Ontario, Canada
Notice bibliographique
Résumé
Introduction Despite the availability of pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and PEP-in-Pocket (PIP), HIV rates among women continue to increase in Canada, and comparator countries have shown lower use of PrEP among women compared to men, along with a lower PrEP-to-need ratio. This cross-sectional survey-based study aimed to characterize women’s assessment of their HIV risk, along with their awareness of, and access to medication-based HIV prophylaxis. Methods The 52-question survey was distributed at 15 community-based organizations in Southern Ontario, Canada, including shelters, addiction treatment and recovery centres, women’s drop-ins, and women’s programming from June 2023 to February 2024. Eligible participants were self-identified women who were prophylaxis-naïve and either sexually active and/or using drugs. Women who identified as HIV-positive were excluded. Results 318 participants were recruited and completed the survey. Self-reported knowledge on HIV transmission, risk, prevention, and testing was high, and women reported multiple ways to decrease risk. 56.6% reported HIV risk factors, including 51.3% who reported one or more sexual risk factors, and 31.1% who reported at least one drug use risk factor. However, of the 302 participants who provided a response regarding self-assessed HIV risk, 93.7% assessed their HIV risk as low or average. Importantly, 48.7% were not aware of PrEP or PEP; 73.3% were not aware of PIP; and 89.0% and 87.8% had never been offered PrEP or PEP, respectively, although interest in both oral and injectable medication was high. Nearly half (48.4%) believed they would not qualify for PrEP, with multiple additional barriers cited, including not being at risk (40.9%), side effects (33.6%), affordability (26.1%), and perceived adherence challenges (17.0%). Discussion This study demonstrates that women’s self-perceived HIV risk is not congruent with objective HIV risk, based on sexual activity or drug use. Most women were not aware of HIV prevention medications and believed they would not be eligible. Of those who thought they would be eligible, less than one-third had been offered HIV prevention medications, although there was a high level of interest for both oral and injectable medication. Conclusion Multiple barriers were cited that limit women's access to HIV prevention medication, and objective risk did not match subjective risk. As such, intensified efforts are required to ensure women are aware of HIV prevention medication, including eligibility, and how to access. Furthermore, additional clinical, public health, and policy efforts are required to engage women in HIV prevention care and to ensure offerings are available.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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 | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 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 ».