Profiles of Willingness to Use Pre-Exposure Prophylaxis Modalities and an HIV Vaccine Among Sexual and Gender Minority Individuals in Brazil, Mexico, and Peru: Cross-Sectional Online Survey
Notice bibliographique
Résumé
BACKGROUND: HIV incidence continues to disproportionately affect sexual and gender minority (SGM) individuals in Latin America. Pre-exposure prophylaxis (PrEP), including long-acting products, urgently need scaling up in the region. Understanding PrEP modality preferences can help design effective implementation. OBJECTIVE: This study examined willingness to use different PrEP modalities and an HIV vaccine among SGM individuals aged 18 years or older from Brazil, Mexico, and Peru and factors associated with willingness to use 4 PrEP modalities. METHODS: We conducted a cross-sectional online survey in 2021; participants were recruited via apps (Grindr and Hornet) and social media (Facebook, Instagram, and WhatsApp). We used multivariate Poisson regression with robust variance (α=.05) to estimate prevalence ratios, identifying differences in willingness to use daily oral, event-driven oral, monthly oral, and bimonthly injectable PrEP. Models were constructed for each PrEP modality and adjusted for age, country, race, education, income, HIV risk score, HIV testing, and HIV risk perception. Variables were retained in the final adjusted models regardless of statistical significance. RESULTS: Among 16,951 respondents, 10,385 (61.3%) were Brazilian, 4996 (29.5%) Mexican, and 1570 (9.3%) Peruvian. Median age was 32 (IQR 26-39) years. Among the total respondents, 12,621 (74.4%) were willing to use monthly oral PrEP; 11,153 (65.8%) daily oral PrEP; 10,212 (60.2%) bimonthly injectable PrEP; and 14,044 (82.8%) an HIV vaccine. Only 6442 (38%) were willing to use event-driven oral PrEP. In Brazil, 6082 (66.8%) were willing to use daily oral, 3162 (36.1%) event-driven, 7640 (74.9%) monthly oral, and 6450 (63.3%) injectable PrEP; in Mexico, 3242 (67.8%) daily oral, 1958 (41%) event-driven, 3728 (76.5%) monthly oral, and 2805 (57.5%) injectable PrEP; in Peru, 799 (53.1%) daily oral, 584 (39.9%) event-driven, 830 (62.5%) monthly oral, and 610 (45.9%) injectable PrEP. In multivariable models, willingness to use each of the 4 PrEP modalities was positively associated with high self-perceived HIV risk (adjusted prevalence ratios [aPRs] 1.10-1.25) and higher HIV Incidence Risk Index scores (aPRs 1.08-1.22). Having lower education was associated with lower willingness for monthly oral and bimonthly injectable PrEP (aPR=0.93, 95% CI 0.89-0.97 and aPR=0.94, 95% CI 0.90-0.99, respectively). Never having been tested for HIV and testing more than 6 months ago were associated with lower willingness for daily oral PrEP (aPR=0.89, 95% CI 0.83-0.95 and aPR=0.95, 95% CI 0.91-0.99, respectively) and bimonthly injectable PrEP (aPR=0.80, 95% CI 0.74-0.86 and aPR=0.90, 95% CI 0.86-0.94, respectively). CONCLUSIONS: Our results suggest a strong preference for long-acting formulations, including monthly oral and bimonthly injectable, among SGM individuals in Latin America. Further research is needed to address gaps in the understanding of prevention modalities. As additional PrEP modalities are included in HIV prevention programs, the development of accessible tools and community-based strategies will be essential to support informed PrEP choices and ensure equitable implementation across the region.
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| 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 source (Gemma direct ou Codex distillé), 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 ».