广西柳州MSM艾滋病非职业性暴露后预防服务的需求和影响因素

Demand for non-occupational post-exposure prophylaxis services for HIV and associated factors among men who have sex with men in Liuzhou, Guangxi

目的分析广西柳州市男男性行为者(men who have sex with men, MSM)对艾滋病非职业性暴露后预防(non-occupational post-exposure prophylaxis, nPEP)服务的需求及相关的影响因素。方法在广西柳州市招募符合纳入标准的MSM。采用面对面调查的方式,收集社会人口学信息、艾滋病相关知识的认知、高危行为史、对nPEP服务的认知和需求等信息。运用χ~2检验分析不同特征和具有不同高危行为的MSM对nPEP服务需求差异,继而运用Log-binomial回归模型分析nPEP服务需求的影响因素,计算现患比(prevalence ratio, PR)和95%置信区间(confidence interval, CI)。结果 MSM人群中有31.1%听说过nPEP服务,告知nPEP服务的相关保护效果后,需要该项服务的占61.6%;58.6%的MSM在发生高危行为后,会花钱购买nPEP服务。Log-binomial回归分析显示,调查对象的文化程度为大专及以上(PR=2.743, 95%CI:1.996~3.450)、对当地MSM艾滋病疫情的感知不严重或不知道(PR=0.211, 95%CI:0.112~0.294)、半年内临时性伴个数为2个及以上(PR=3.642, 95%CI:2.223~4.842)为调查对象对nPEP服务需求的影响因素。结论广西柳州地区的MSM人群对于nPEP服务有一定的需要,应结合当地情况尽早推行nPEP服务,加强相应的宣教,以降低艾滋病对MSM人群的危害。

Objective To analyze the demand for non-occupational post-exposure prophylaxis(nPEP) services and related influencing factors among men who have sex with men(MSM) in Liuzhou City, Guangxi Province. Methods MSM was recruited in Liuzhou City, Guangxi Province. Face-to-face survey was used to collect demographic information, knowledge about AIDS, history of high-risk behavior, knowledge and demand for nPEP services. χ~2 test was used to analyze the differences of demand for nPEP services among MSM with different characteristics and different high-risk behaviors. Log-binomial regression model was used to analyze the influencing factors of demand for nPEP services. Prevalence ratio and 95% confidence interval were calculated. Results 31.1% of MSM population had heard of nPEP service, and 61.6% of them needed the service after being informed of nPEP about its protective effect. 58.6% of MSM would spend money to buy nPEP service after high-risk behavior. Logistic regression analysis showed that the education level was university degree or above(PR=2.743, 95% CI: 1.996-3.450), the perception of the local MSM AIDS epidemic was not serious or unknown(PR=0.211, 95% CI: 0.112-0.294), and the number of temporary sexual partners in half a year was 2 or more(PR=3.642, 95% CI: 2.223-4.842), these subjects above were influencing factors of nPEP service demanded for respondents. Conclusions MSM population in Liuzhou area of Guangxi have a certain need for nPEP service. We should implement nPEP service as soon as possible in accordance with local conditions, and strengthen the corresponding propaganda to reduce the harm of AIDS to MSM population.