暗娼HIV暴露前药物预防临床试验意愿调查

Willingness to participate in HIV pre-exposure prophylaxis clinical trials among female sex workers

目的了解广西女性性工作者(FSWs)对艾滋病病毒(HIV)暴露前药物预防(PrEP)临床试验的参与意愿及其影响因素。方法采用横断面调查方法于2009年11月—2010年2月在广西南宁市、柳州市、北海市共招募348名FSWs进行问卷调查。结果 348名调查对象中PrEP的知晓率为14.9%(52/348);54.3%(189/348)的FSWs表示愿意参加PrEP临床试验,不愿意参加的主要原因是:81.8%(130/159)的FSWs担心PrEP的副作用,42.8%(68/159)的FSWs担心PrEP无效果,27.7%(44/159)的FSWs认为自己没有感染HIV的危险,没必要参加;近半年与嫖客、配偶/固定性伴、临时性伴(不付费)发生性行为时每次都使用安全套者分别占78.4%(273/348)、25.2%(67/266)、70.9%(134/189);多因素logistic回归分析结果表明,PrEP临床试验的影响因素为目前居住地、能坚持每天服用药物、认为有能力预防HIV感染、与家人的关系好、场所业主会影响选择服用药物、担心使用药物被他人歧视。结论场所业主、家人的支持及他人的歧视是广西FSWs参与PrEP临床试验的重要影响因素,联合干预和减少歧视可能是提高其参与意愿的有效措施。

Objective To explore the willingness towards participation of HIV pre-exposure prophylaxis（PrEP） clinical trials and its influencing factors among female sex workers（FSWs） in Guangxi Zhuang Autonomous Region,China.Methods A cross-sectional study using convenience sampling was conducted.A total of 348 FSWs were recruited from three cities（Nanning,Liuzhou and Beihai） in Guangxi.Results Among the 348 paticipants,the awareness rate of PrEP was only 14.9%（52/348） and 54.3%（189/348） of the FSWs were willing to participate in the clinical trial of PrEP.The main reason of reluctant to the participation was the fear of PrEP side effects（81.8%）.Logistic regression analyses showed that the influencing factors of the participation of PrEP were current residence（odds ratio=2.598,95% confidence interval：1.395-4.838）,sticking to take PrEP everyday（OR=2.581,95%CI：1.486-4.481）,having the ability to prevent HIV infection（OR=1.843,95%CI：1.070-3.174）,having good relationship with family members（OR=1.990,95%CI：1.120-3.535）,influence of the site owners（gatekeepers）（OR=0.550,95%CI：0.329-0.918）,and concerns about discrimination by others when using the PrEP（OR=0.285,95%CI：0.167-0.488）.Conclusion Site owners（gatekeepers）,family support and discrimination of others are important influencing factors in PrEP clinical trials among FSWs in Guangxi.The results suggest that comprehensive interventions and decreasing discrimination may effectively promote the willingness of PrEP.