Chomchey Nitiya, Woratanarat Thira, Hiransuthikul Narin, Lertmaharit Somrat, Lohsoonthorn Vitool, Teeratakulpisarn Nipat, Pinyakorn Suteeraporn, Fletcher James Lk, Suttichom Duanghathai, Phanuphak Praphan, Ananworanich Jintanat, Phanuphak Nittaya
SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Virus Erad. 2017 Jul 1;3(3):128-139. doi: 10.1016/S2055-6640(20)30331-9.
Men who have sex with men (MSM) are disproportionately infected with HIV in Thailand. Factors affecting their intention to take non-occupational HIV post-exposure prophylaxis (nPEP) are not well understood. This study sought to determine factors associated with an intention to take nPEP in this population.
This is a two-phase mixed-method study. Phase I was a cross-sectional survey of intention to take nPEP in 450 MSM attending for HIV testing, using a self-administered questionnaire. Phase II was a prospective descriptive study, using an in-depth interview among 40 MSM who had been exposed to HIV in the past 72 hours. Multiple logistic regression was used to evaluate factors relating to the intention to use nPEP.
Among 450 MSM seeking HIV testing in Bangkok, 7% had ever taken nPEP. Only 40% expressed an intention to take it to prevent HIV acquisition, despite the fact that they were at high risk as evidenced by an 18.9% prevalence of HIV-positive status. Factors associated with an intention to take nPEP were awareness about nPEP, HIV knowledge, mode of sexual intercourse and circumcision. Among 40 MSM who were eligible for and offered nPEP, 39 agreed to take it, and all but one completed the 4-week course. Condom use increased and all 32 individuals who could be contacted tested HIV negative after nPEP.
A high HIV prevalence was found in MSM testing for HIV in this study. However, fewer than half of the participants expressed the intention to take nPEP if they were at risk for HIV infection. Efforts to create nPEP awareness and improve HIV knowledge in MSM are crucial to the successful implementation of nPEP as part of a combination package for HIV prevention in this high-risk population.
在泰国，男男性行为者（MSM）感染艾滋病毒的比例过高。影响他们采取非职业性艾滋病毒暴露后预防（nPEP）意愿的因素尚未得到充分了解。本研究旨在确定该人群中与采取nPEP意愿相关的因素。
这是一项两阶段的混合方法研究。第一阶段是对450名前来进行艾滋病毒检测的男男性行为者采取nPEP的意愿进行横断面调查，使用自填式问卷。第二阶段是一项前瞻性描述性研究，对过去72小时内暴露于艾滋病毒的40名男男性行为者进行深入访谈。采用多因素逻辑回归来评估与使用nPEP意愿相关的因素。
在曼谷寻求艾滋病毒检测的450名男男性行为者中，7%的人曾服用过nPEP。尽管他们处于高风险状态，艾滋病毒阳性率为18.9%，但只有40%的人表示愿意服用nPEP以预防艾滋病毒感染。与采取nPEP意愿相关的因素包括对nPEP的认知、艾滋病毒知识、性交方式和包皮环切术。在40名符合条件并被提供nPEP的男男性行为者中，39人同意服用，除一人外，所有人都完成了为期4周的疗程。使用避孕套的情况增加，在接受nPEP后，所有32名能够联系到的人艾滋病毒检测均为阴性。
本研究中接受艾滋病毒检测的男男性行为者艾滋病毒感染率很高。然而，如果他们有感染艾滋病毒的风险，不到一半的参与者表示愿意采取nPEP。在男男性行为者中提高对nPEP的认知并改善艾滋病毒知识，对于成功实施nPEP作为该高危人群艾滋病毒预防综合方案的一部分至关重要。
