ABSTRACT
Post-exposure prophylaxis (PEP) has been proposed as a strategy to prevent the acquisition of HIV infection after certain high-risk exposures, and treatment as prevention (TasP) is also being advocated as a means to reduce sexual transmission of HIV. The aim of this study was to investigate the prevalence of PEP and TasP awareness and their demographic, behavioral, and social correlates in Italy. We conducted a cross-sectional survey of 1,028 high-risk heterosexual men and women, 1,874 non-HIV positive MSM (men who have sex with men), and 694 people living with HIV/AIDS (PLWHA). The majority of the participants was aware of PEP and unaware of TasP. MSM were less knowledgeable about PEP and TasP than were PLWHA and more knowledgeable about PEP and TasP than were high-risk heterosexual participants. The variables most consistently associated with PEP and TasP awareness were contact with HIV/AIDS organizations, HIV testing, and HIV stigma. A positive relationship between unprotected sexual intercourse and PEP and TasP awareness was found among high risk heterosexual participants, while this association was not significant among MSM and PLWHA. Because PEP and TasP are currently recommended, effective educational and dissemination strategies are needed to increase the level of knowledge about PEP and TasP.
Subject(s)
HIV Infections/prevention & control , HIV Infections/transmission , Post-Exposure Prophylaxis , Adolescent , Adult , Cross-Sectional Studies , Female , HIV/isolation & purification , HIV Infections/diagnosis , HIV Infections/epidemiology , Health Knowledge, Attitudes, Practice , Heterosexuality , Homosexuality, Male , Humans , Italy/epidemiology , Male , Middle Aged , Patient Education as Topic , Post-Exposure Prophylaxis/methods , Social Stigma , Socioeconomic Factors , Unsafe Sex , Young AdultABSTRACT
The aim of this study was to develop a new 29-item HIV/AIDS knowledge measure and to examine its psychometric properties for three samples of adults: non-HIV-positive heterosexual people, non-HIV-positive men who have sex with men (MSM), and people living with HIV/AIDS (PLWHA). The authors collected data using an online questionnaire. A total of 9,349 Italian individuals agreed to participate in the study: 694 individuals (7.4%) were PLWHA, 5,232 (56.0%) were HIV negative, and the remaining 3,423 (36.6%) were MSM. Using two-parameter item response theory analysis, a bifactor model was found to be better fitting than a one-factor model or a 12 correlated first-order factor model. Differential item functioning showed evidence of measurement nonequivalence of the instrument for the three samples of adults. The reliability of HIV/AIDS knowledge scale among PLWHA was satisfactory. Criterion-related validity was only achieved among non-HIV-positive heterosexual people, non-HIV-positive MSM, as the HIV/AIDS knowledge scale was related with attitudes toward condom use, condom use with casual partners, unknown HIV status of partner, and HIV stigma. Among non-HIV-positive heterosexual people, the HIV/AIDS knowledge scale adds to the prediction of condom use above that of attitudes toward condom use scale. The HIV/AIDS knowledge scale is especially discriminating at low to medium levels of knowledge.
