男男性行为者HIV非职业暴露后预防用药现状及影响因素定性研究

Qualitative study on taking HIV non-occupational post-exposure prophylaxis and its influencing factors among men who have sex with men

目的从不同人群视角了解MSM的HIV非职业暴露后预防用药(nPEP)现状及影响因素。方法采用便利抽样法,选择具有/没有nPEP服药经历的MSM、男同社区小组工作人员及医务工作者进行一对一定性访谈。结果共访谈MSM 13名,男同社区小组工作人员和医务工作者各5名。其中具有nPEP服药经历MSM 7名,nPEP平均知识得分9分(满分11分)。男同社区小组工作人员及医务工作者的防艾工作年限分别为10(8,20)年和8(6,20)年。访谈发现被动肛交中途摘套是MSM选择nPEP的主要驱动事件;使用nPEP的MSM具有自我决策水平低、购药途径多样化、服药过程中随访率低等问题。购药门槛高成为影响MSM选择nPEP的主要阻碍因素;对于多次服用nPEP的MSM具有向PrEP转变的可能性。结论当前MSM使用nPEP的自我决策效能较低,互联网医院成为其购买nPEP的主要选择途径。未来应加强对nPEP相关的研究,尤其是互联网医院在nPEP使用中的作用及可能存在的问题研究。

Objective To understand HIV nonoccupational post-exposure prophylaxis(nPEP)uptake and its influencing factors among men who have sex with men(MSM)from different population perspectives.Methods A convenience sampling method was used to enroll MSM with/without experience of nPEP usage,gay community workers,and medical staff for one-on-one qualitative interviews.Results A total of 13 MSM,5 gay community working staff and 5 medical staff were enrolled in the study.7 out of 13 MSM used nPEP before the interview,and the median score of nPEP knowledge among MSM was 9(total score was 11).The numbers of years working in HIV prevention and controlfor the gay community and medical staff were 10(8,20)and 8(6,20)years,respectively.Passive anal sex with a condom removed midway was the main driving event for choosing nPEP.Topics such as low self-efficacy,diverse routes to purchase nPEP medication,low follow-up rates,and feasibility of transiting from nPEP to PrEP were found during nPEP usage.Poor drug accessibility was the main obstacle to nPEP use.Conclusions MSM had low self-efficacy in using nPEP.They mainly buy nPEP from internet hospitals.Further research is needed,especially to explore the role of internet hospitals in nPEP usage.