基于结构方程模型的广西男男性行为者长效注射剂卡博特韦使用意愿及影响因素研究

The willingness and influencing factors of using long-acting injectable cabotegravir among men who have sex with men in Guangxi based on a structural equation model

目的了解广西MSM长效注射剂卡博特韦(CAB-LA)使用意愿及影响因素,为今后CAB-LA在我国的推广应用提供科学依据。方法采用横断面调查的方法于2022年3-7月招募MSM进行面对面问卷调查,分析CABLA使用意愿并基于结构方程模型分析其使用意愿的影响因素及其作用路径和效应。结果共调查1006名MSM,年龄为18~24岁占34.0%,未婚占80.5%,本科及以上学历占40.0%。研究对象CAB-LA使用意愿为79.8%;18~24岁年龄组、近6个月男性性伴数多、自我感知HIV感染风险较高和使用过口服PrEP的MSM对CAB-LA使用意愿更高。结构方程模型显示,年龄、月收入、婚姻状况、近6个月经公共场所寻找男性性伴、近6个月男性性伴数、近1个月有固定男性性伴、自我感知HIV感染风险、对抗反转录病毒药物(ARVs)疗效看法和口服PrEP使用经历是CAB-LA使用意愿的影响因素,总效应分别为-0.127、-0.069、0.071、0.077、0.112、0.092、0.114、0.067和0.088;其中近6个月经公共场所寻找男性性伴通过近6个月男性性伴数产生间接作用,近6个月男性性伴数通过自我感知HIV感染风险和口服PrEP使用经历产生间接作用,口服PrEP使用经历通过对ARVs疗效看法产生间接作用。结论广西MSM对CABLA的使用意愿较高,尤其是年轻、多性伴、自我感知HIV感染风险高和使用过口服PrEP的MSM,可作为我国今后CAB-LA试点和推广工作的重点人群。

Objective To explore the willingness and influencing factors of using long-acting injectable cabotegravir(CAB-LA)among men who have sex with men(MSM)in Guangxi,so as to provide scientific evidence for the future implementation of CAB-LA in China.Methods Using a cross-sectional survey method,MSM were recruited for a face-to-face questionnaire survey from March to July 2022.A structural equation model was used to explore the pathways,effects,and influencing factors of the willingness for CAB-LA use.Results A total of 1006 MSM were recruited.Of these,34.0%were aged 18-24 years old,80.5%were unmarried,and 40.0%had a bachelor's degree or higher;the willingness to use CAB-LA was 79.8%.MSM aged 18-24 years old,with more homosexual partners in last 6 months,higher self-perceived risk of HIV infection and the experience of oral pre-exposure prophylaxis(PrEP)use were more likely to use CAB-LA.The results of the structural equation model indicated that,age,monthly income,marital status,having sought homosexual partners in public venues in last 6 months,number of homosexual partners in last 6 months,having regular homosexual partners in the last month,self-perceived risk of HIV infection,perceived efficacy of antiretroviral drugs(ARVs)and the experience of oral PrEP use were the association factors of the willingness of using CAB-LA,with the total effect of-0.127、-0.069、0.071、0.077、0.112、0.092、0.114、0.067 and 0.088,respectively.Having sought partners in public venues in last 6 months indirectly affected the willingness of using CAB-LA through the number of homosexual partners in last 6 months.The number of homosexual partners in last 6 months indirectly affected the willingness of using CAB-LA through self-perceived risk of HIV infection and the experience of oral PrEP use.The experience of oral PrEP use indirectly affected the willingness of using CAB-LA through perceived efficacy of ARVs.Conclusions Willingness to use CAB-LA among MSM in Guangxi was relatively high,particularly among MSM who were young,had multiple sexual partners,had higher self-perceived risk of HIV infection and were using oral PrEP,that could be considered as the key population for future CAB-LA piloting and promotion work in China.