青岛市使用男同社交软件的男男性行为者HIV暴露后预防使用现状及影响因素分析

Current status and factors of the usage of HIV post-exposure prophylaxis among men who have sex with men utilizing gay social applications in Qingdao City

目的了解青岛市使用男同社交软件的MSM HIV nPEP使用情况,并分析相关影响因素。方法于2023年8-12月,通过山东省青岛市某社会公益组织招募年龄≥18周岁、生理性别为男性、开展调查前6个月内发生过男男性行为、自报HIV感染状态为阴性或未知、使用过男同社交软件的MSM作为研究对象,利用自行设计的电子调查问卷收集研究对象的一般人口学信息、HIV检测史、nPEP使用史、高危性行为史等资料,采用非条件Logistic回归模型分析nPEP使用的影响因素,利用限制性立方样条(RCS)进一步分析男同社交软件使用频次(天/周)与使用nPEP的剂量-反应关系。结果共收集有效问卷315份,12.7%(40/315)的研究对象使用过nPEP。非同性性向(OR=4.95,95%CI:1.37~17.84)、nPEP知识得分越高(OR=1.36,95%CI:1.04~1.77)、使用过PrEP(OR=8.51,95%CI:2.90~24.95)是nPEP使用的促进因素;不方便获取nPEP相关药品(OR=0.24,95%CI:0.06~0.93)是nPEP使用的阻碍因素。男同社交软件使用频次越高(OR=1.03,95%CI:0.85~1.27),研究对象使用nPEP的可能性越高。结论青岛市使用男同社交软件的MSM nPEP使用率较低,未来应重点关注男同社交软件在促进MSM HIV生物学预防措施利用方面的作用机制及效果。

Objective This study aimed to investigate the usage of non-occupational post-exposure prophylaxis(nPEP)among men who have sex with men(MSM)utilizing gay social applications in Qingdao,and related factors.Methods From August to December 2023,MSM aged 18 or older,biologically male,who had engaged in male-male sexual behavior in the six months prior to the survey,self-reported as HIV-negative or of unknown status,and who used gay social applications were recruited via a social public welfare organization in Qingdao City,Shandong Province.Data were collected using a self-designed electronic questionnaire that included demographic information,HIV testing history,nPEP usage history,and history of high-risk sexual behaviors.Unconditional logistic regression models analyzed the factors influencing nPEP use,while restricted cubic splines(RCS)examined the dose-response relationship between the frequency of gay social app usage(days per week)and nPEP usage.Results A total of 315 valid questionnaires were collected.Of these,12.7%(40/315)of participants had used nPEP.Factors facilitating nPEP use included non-homosexual orientation(OR=4.95,95%CI:1.37-17.84),higher nPEP knowledge scores(OR=1.36,95%CI:1.04-1.77),and previous PrEP use(OR=8.51,95%CI:2.90-24.95).Conversely,difficulty obtaining nPEP-related drugs was a significant barrier(OR=0.24,95%CI:0.06-0.93).Higher frequency of using gay social applications was associated with increased nPEP use(OR=1.03,95%CI:0.85-1.27).Conclusions The usage rate of nPEP among MSM using gay social applications in Qingdao is relatively low.Future initiatives should focus on enhancing the mechanisms and effectiveness of these applications in promoting HIV biomedical prevention measures among MSM.