我国六城市MSM暴露前预防使用状况及影响因素分析

The utilization of pre-exposure prophylaxis and related factors among MSM in six cities in China

目的了解MSM暴露前预防(PrEP)使用状况以及相关因素。方法2022年9月30日至10月30日,采取方便抽样,分别在天津、沈阳、杭州、合肥、深圳、重庆的MSM社会组织招募年龄18岁及以上、自报最近一次HIV检测结果为阴性或从未检测过HIV和半年内发生过同性性行为的男性作为研究对象,通过自行设计的电子问卷收集人口学、行为学、HIV感染风险感知情况及PrEP使用等信息。采用Logistics回归模型分析PrEP使用的相关因素。结果共调查符合纳入标准的MSM 2388名,大专及以上文化程度占73.7%(1760人),性向为同性恋占83.8%(2000人),使用过PrEP的比例为13.9%(333人)。多因素Logistics回归分析显示,文化程度为研究生及以上(OR=2.56,95%CI:1.57~4.17)、性向为同性恋(OR=2.05,95%CI:1.37~3.07)、自我感觉感染HIV的风险为中或高风险(OR=1.60,95%CI:1.21~2.12)、近6个月内发生过同性无套性行为(OR=1.43,95%CI:1.09~1.86)、使用过nPEP(OR=5.41,95%CI:4.11~7.13)、HIV检测频率为一年4次及以上(OR=3.16,95%CI:1.19~8.39)的MSM更可能使用PrEP。结论调查六城市MSM对PrEP利用不足,可结合现有HIV干预措施如nPEP、HIV检测,加强MSM(尤其是低文化程度)的HIV风险感知意识教育,以促进MSM利用PrEP。

Objective To investigate the utilization of pre-exposure prophylaxis(PrEP)and related factors in men who have sex with men(MSM).Methods From September 30 to October 30,2022,we recruited MSM aged 18 selfreported negative result for the most recent HIV test or never tested for HIV and above who have had homosexual behavior in recent six months via MSM social organizations in Tianjin,Shenyang,Hangzhou,Hefei,Shenzhen,and Chongqing as research subjects.We collected demographic,behavioral,HIV risk perception,and PrEP utilization information through self-designed electronic questionnaires.The logistics regression model was used to analyze the factors associated with PrEP utilization.Results A total of 2,388 MSM respondents who met the inclusion criteria were enrolled in this study.73.7%(1760/2388)had a college education or above.83.8%(2000/2388)were identified as homosexual and 13.9%(333/2388)had used PrEP.Multivariate logistics regression analysis showed that factors related to PrEP use included having an education level of postgraduate and above(OR=2.56,95%CI:1.57-4.17),being identified as gay(OR=2.05,95%Cl:1.37-3.07),being self-perceived with a moderate or high risk of HIV infection(OR=1.60,95%CI:1.21-2.12),and having had condomless same-sex behaviors in the past 6 months(OR=1.43,95%CI:1.09-1.86),having used nPEP(OR=5.41,95%CI:4.11-7.13),and having been tested with HIV at least 4 times within one year(OR=3.1695%CI:1.19-8.39).Conclusions The uptake of PrEP service is relatively low among MSM in six cities in China.We should strengthen HIV risk awareness education in MSM(especially low education level)in combination with existing HIV interventions such as nPEP and HIV testing to promote the use of PrEP in MSM.