男男性行为者对暴露前预防的使用意愿及其影响因素的系统评价

A systematic review of MSM willingness in using the pre-exposure prophylaxis and related influencing factors

目的系统评价MSM对暴露前预防(PrEP)的使用意愿及其影响因素。方法计算机检索PubMed、The Cochrane Library、EMBASE、CINAHL、CNKI、WanFang data、CBM和VIP数据库,搜集MSM对PrEP的使用意愿、兴趣或接受程度的横断面研究,检索时限从建库至2020年8月12日。由2名具有循证医学背景的研究者独立筛选、提取资料并评价纳入各个研究的质量后进行描述性分析。结果共纳入了54篇研究,包括了60863例研究对象。定性分析结果显示:MSM对PrEP的使用意愿水平较高,但实际使用率低,主要与影响其使用意愿的因素有关。促进其使用意愿的因素包含9个,包括存在高危性行为、个人风险感知水平高以及药物免费或低价格提供等;阻碍其使用意愿的因素包含7个,包括担心药物不良反应以及怀疑药物效果等。结论PrEP在MSM中呈现出高需求与低使用的现实差距,建议医务工作者根据其使用意愿的促进和阻碍因素制订相关策略和举措,以促进PrEP在MSM中广泛推广和使用。

Objective To systematically describe and analyze the influencing factors associating with the willingness of MSM to use preexposure prophylaxis(PrEP).Methods Computer-assisted manual retrieval of a cross-sectional study on the desire,interest,and acceptance of MSM to use PrEP in 8 Chinese and English databases(PubMed,CINAHL,The Cochrane Library,EMBASE,China Biomedical Literature Database,CNKI,VIP,Wanfang).Two researchers carried out literature screening,data extraction and quality evaluation according to inclusion and exclusion.The study results were summarized by qualitative synthesis.Result A total of 54 cross-sectional studies were included in this review.Qualitative analysis showed that the factors affecting the Willingness of MSM to use PrEP including promotion and hindrance factors.Conclusion There showed a realistic gap between high demand and low take of PrEP among MSM.It is recommended that healthcare workers develop relevant strategies and measures according to the promotion and hindrance factors of their willingness to use to promote the widespread acceptance and use of PrEP in MSM.