长沙市295名男性同性行为对暴露前预防用药的意愿和影响因素分析

Willingness and influencing factors of HIV pre-exposure prophylaxis for 295 men who have sex with men in Changsha

目的 了解长沙市男性同性行为(men who have sex with men,MSM)对HIV暴露前预防(pre-exposure prophylaxis,PrEP)用药意愿及影响因素。方法 于2020年1-12月在长沙市MSM人群哨点监测站采用问卷调查开展横断面研究。不同特征MSM对PrEP服务需求影响的差异采用χ2检验进行单因素分析,建立logistic回归模型进行多因素分析。结果 54.20%的MSM人群听说过PrEP,其中有30.80%表示愿意接受PrEP,知晓率高于使用意愿。月收入水平(χ^(2)=17.037,P<0.05)、对当地MSM感染艾滋病疫情感知情况(χ^(2)=8.449,P<0.05)、是否出现过安全套破裂或滑脱等危险性性行为(χ^(2)=9.916,P<0.05)以及最近6个月内是否有同性商业性行为(χ^(2)=6.717,P<0.05)与PrEP服务需求差异有统计学意义。月经济收入水平高、出现过安全套破裂或滑脱等危险性性行为、认为当地MSM艾滋病疫情严重的MSM更愿意使用PrEP服务,OR值分别为3.339、3.710、2.517。结论 长沙市MSM以年轻、文化较高的单身人群为主,PrEP服务的人群知晓率较高,使用意愿低于知晓率,存在知晓与行动相分离的现象。月收入水平、对当地MSM感染艾滋病疫情感知、是否出现过安全套破裂或滑脱等与对PrEP服务的需求有关。

Objective To understand the needs and influencing factors of men who have sex with men(MSM)for HIV pre-exposure prophylaxis(PrEP)in Changsha.Methods A cross-sectional study was conducted using the on-site questionnaire survey method in MSM Sentinel of Changsha from January to December 2020.MSM with different characteristics was used to test the difference in PrEP service demand.Single-factor analysis was performed,and an unconditional two-category logistic regression model was used for multivariate analysis.Results Approximately 54.20%of MSM had heard of PrEP,and 30.80%expressed their willingness to accept PrEP.The awareness rate was higher than the willingness to use it.Monthly income level(χ^(2)=17.037,P<0.05),perception of local MSM infection with AIDS(χ^(2)=8.449,P<0.05),dangerous sexual behaviours such as condom rupture and slippage(χ^(2)=9.916,P<0.05)and same-sex commercial sex in the last 6 months(χ^(2)=6.717,P<0.05)were determined.The differences were statistically significant between the PrEP service demand and above factors.MSM with high monthly income,having dangerous sexual behaviours such as condom rupture or slippage,and believing that the local MSM AIDS epidemic was serious were more willing to use prep services,the corresponding OR values were 3.339,3.710 and 2.517,respectively.Conclusion The MSM in Changsha City is dominated by young and highly educated singles.The awareness rate of PrEP services is relatively high,and the willingness to use it is lower than the awareness rate.There is a phenomenon of separation of awareness and action.Monthly income level,perception of local MSM infection with HIV and history of dangerous sexual behaviours such as condom rupture and slippage are related to the demand for PrEP services.