RESUMEN
Background: Experiencing high levels of stress during pregnancy can impair maternal well-being and fetal development. Consequently, unbiased assessment of maternal psychological state is crucial. Self-report measures are vulnerable to social desirability effects. Thus, implicit measures, such as word choice analysis, may offer an alternative. Methods: In this longitudinal online-study, 427 pregnant women described their emotional experiences in writing and additionally responded to self-report questionnaires assessing symptoms of prenatal stress and depression. The written texts were analyzed with a computerized text analysis program. After birth, 253 women provided information on birth outcome. Results: Word use differed significantly depending on maternal socioeconomic (e.g., marital status) and pregnancy-related characteristics (e.g., parity). Prenatal stress and depressive symptoms were associated with more frequent use of negative emotion words and words of anxiety, as well as with less first-person plural, but not singular pronoun use. Negative emotion and cognitive mechanism words predicted birth outcome, while self-report measures did not. Conclusion: In addition to self-report measures, word choice may serve as a useful screening tool for symptoms of depression and stress in pregnant women. The findings on pronoun use may reflect women's changing experience of self-identity during the transition to motherhood.
RESUMEN
AIM: The aim of this study was to determine the intention to use pre-exposure prophylaxis (PrEP) when available and to identify predictors of the intention to use PrEP among men who have sex with men (MSM) living in Switzerland. The theoretical model drew on the Unified Theory of Acceptance and Use of Technology and considered additional variables related specifically to PrEP, HIV protection and the resources of MSM. SUBJECT AND METHODS: For data collection, we used an anonymous, standardized self-administered online questionnaire. In 2015, we gathered a convenience sample of 556 HIV-negative MSM living in Switzerland. We analyzed the data using descriptive and bivariate statistics and used structural equation modeling to test the hypothesized model. RESULTS: Predictors of respondents' moderate intention to use PrEP were performance expectancy, effort expectancy, perceived social influence, concerns about using PrEP, attitudes toward condom use, negative experiences of condom use and age. These variables were predicted by HIV protection-related aspects and resources. CONCLUSION: The findings provide insights into the complex dynamic underlying the intention to use PrEP.
RESUMEN
Pre-exposure prophylaxis (PrEP) is discussed as an additional HIV prevention method targeting men who have sex with men (MSM). So far, PrEP has not been approved in Switzerland and only little is known about the acceptability of PrEP among MSM living in Switzerland. Given the slow uptake of PrEP among MSM in the USA, the objectives of the study were to investigate the acceptability for PrEP and to identify factors influencing the acceptability for this prevention method and the willingness to adopt it. During a 4-month period we conducted five focus group discussions with 23 consecutively sampled HIV-negative MSM aged 22-60 years living in Switzerland. We analyzed the data according to qualitative content analysis. The acceptability of PrEP varied considerably among the participants. Some would use PrEP immediately after its introduction in Switzerland because it provides an alternative to condoms which they are unable or unwilling to use. Others were more ambivalent towards PrEP but still considered it (1) an additional or alternative protection to regular condom use, (2) an option to engage in sexual activities with less worries and anxieties or (3) a protection during receptive anal intercourse independently of the sexual partner's protective behaviour. Some participants would not consider using PrEP at all: they do not see any benefit in PrEP as they have adopted safer sex practices and did not mention any problems with condom use. Others are still undecided and could imagine using an improved form of PrEP. The results provide a valuable basis for a model explaining the acceptability of PrEP among MSM and suggest including the personal HIV protection strategy in the considerations adopted.