北京市男男性行为人群HIV暴露前预防使用及相关因素分析

Pre-exposure prophylaxis against HIV and the related factors among MSM in Beijing

目的了解北京市男男性行为人群(men who have sex with men,MSM)对HIV暴露前预防(pre-exposure prophylaxis,PrEP)的使用情况,并对PrEP使用的相关因素进行分析。方法在北京市通过某男男性行为人群手机交友软件招募MSM作为调查对象。采用自行设计的网络问卷进行横断面调查,收集调查对象的基本信息、性行为情况、PrEP基本知识知晓以及使用情况。采用χ^(2)检验比较不同特征调查对象间PrEP使用情况的差异;然后采用多因素logistic回归,分析PrEP使用的相关因素。结果共纳入1201名调查对象,以18~29岁为主,占52.5%(631名);学历主要集中在本科及以上(77.9%);月收入以1万元以上为主,占45.4%(545名)。PrEP的使用比例为12.9%(155名),月收入1万元以上、近6个月发生过无保护肛交、近6个月发生过商业性行为、近12个月内HIV检测4次及以上、曾使用过HIV暴露后预防,以及能够掌握PrEP基本知识者使用PrEP的可能性更高。结论北京市MSM人群PrEP的使用比例相对较低,还应继续加强宣传力度,提高PrEP认知;同时强调在进行HIV咨询检测和提供HIV暴露后预防相关服务时,应注意对服务对象高危行为的识别,主动提供PrEP的宣传和咨询,提高适用人群PrEP的使用率。

Objective To investigate the usage of pre-exposure prophylaxis(PrEP)among men who have sex with men(MSM)in Beijing,and analyze the related factors of using PrEP.Methods MSM were recruited as study subjects through a mobile dating application in Beijing,and a cross-sectional survey was conducted using a self-designed online questionnaire to collect basic information,sexual behavior,basic knowledge of PrEP and usage of PrEP.The differences in using PrEP among MSM with different characteristics were compared using chi-square test,and the related factors of using PrEP were analyzed by multivariate logistic regression.Results A total of 1201 MSM were enrolled in the study.The subjects were mainly 18-29 years old,accounting for 52.5%(631).For the levels of education,the subjects were main undergraduate and above(77.9%).For the monthly income,the subjects were mainly over 10000 yuan,accounting for 45.4%(545 subjects).The usage rate of PrEP was 12.9%(155 subjects).Higher possibility of using PrEP related to monthly income of over 10000 yuan,unprotected anal intercourse in the past 6 months,commercial sexual activity in the past 6 months,HIV testing 4 or more times in the past 12 months and having basic knowledge of PrEP.Conclusions The proportion of PrEP usage among the MSM population in Beijing was relatively low,and further efforts should be made to strengthen publicity and improve PrEP awareness.At the same time,it is emphasized that when conducting HIV counseling and testing as well as providing HIV pro-exposure prophylaxis related services,high-risk behaviors of service recipients should be identified,and to provide actively PrEP promotion and counseling to improve PrEP usage rate among the applicable population.