Bull Lauren, Dimitrijevic Pavle, Beverley Sophie, Scarborough Alex, Mandalia Sundhiya, Dosekun Olamide, Barber Tristan, Reeves Iain, McCormack Sheena, Rayment Michael
1 Chelsea and Westminster Hospital, London, UK.
2 Imperial College Healthcare NHS trust, London, UK.
Int J STD AIDS. 2018 Apr;29(5):435-442. doi: 10.1177/0956462417730259. Epub 2017 Sep 20.
HIV pre-exposure prophylaxis (PrEP) has proven efficacy in reducing the risk of HIV infection in men who have sex with men (MSM), but has not yet been commissioned in the UK. The aim of this study was to investigate perceived need and benefit (or experience of) PrEP among HIV-negative MSM attending sexual health clinics. HIV-negative MSM attending three sexual health centres in London, UK were opportunistically invited to complete a questionnaire. Data collected comprised demographic data and sexual and drug use behaviours as well as questions regarding perceptions of risk and need for PrEP. Logistic regression analysis was undertaken to identify variables predicting acceptability of, and intention to use, PrEP. In addition, data were gathered in respondents already taking PrEP. Eight hundred and thirty-nine questionnaires were analysed. The median age of respondents was 35 years (IQR 28-41, range 18-78), 650 (77%) were of white ethnicity and 649 (77%) had a university education. Four hundred and fifty-six (54%) reported at least one episode of condomless anal sex in the preceding three months, 437 (52%) reported recreational drug use in the preceding three months and 311 (37%) had been diagnosed with a sexually transmitted infection within the preceding six months. Four hundred and sixty-three (64%) of 726 strongly agreed with the statement 'I think I would benefit from PrEP'. Multivariate logistic regression analysis demonstrated that having receptive anal intercourse (RAI) without condoms, having an awareness of the risk of unprotected RAI and having belief in the effectiveness of PrEP were independent predictors for someone thinking they would benefit from taking PrEP. Eight percent of respondents (59/724) had already taken or were currently taking PrEP. The results suggest that individuals at risk are likely to perceive themselves as benefiting from PrEP. The majority perceived their risk of acquiring HIV and benefit from PrEP accurately. Overall they appeared to have little concern over the use of PrEP and generally positive attitudes. Further investigation is warranted to understand why those at risk do not perceive benefit from PrEP.
艾滋病毒暴露前预防（PrEP）已被证明在降低男男性行为者（MSM）感染艾滋病毒的风险方面具有疗效，但在英国尚未得到推广。本研究的目的是调查在性健康诊所就诊的艾滋病毒阴性男男性行为者对PrEP的感知需求和益处（或使用体验）。在英国伦敦的三个性健康中心就诊的艾滋病毒阴性男男性行为者被机会性地邀请填写一份问卷。收集的数据包括人口统计学数据、性和药物使用行为，以及关于风险感知和PrEP需求的问题。进行逻辑回归分析以确定预测PrEP可接受性和使用意愿的变量。此外，还收集了已经在服用PrEP的受访者的数据。对839份问卷进行了分析。受访者的中位年龄为35岁（四分位间距28 - 41，范围18 - 78），650人（77%）为白人，649人（77%）拥有大学学历。456人（54%）报告在过去三个月中至少有一次无保护肛交，437人（52%）报告在过去三个月中使用过娱乐性药物，311人（37%）在过去六个月内被诊断患有性传播感染。在726名受访者中，463人（64%）强烈同意“我认为我将从PrEP中受益”这一说法。多变量逻辑回归分析表明，有无保护的接受肛交（RAI）、意识到无保护RAI的风险以及相信PrEP的有效性是认为自己会从服用PrEP中受益的独立预测因素。8%的受访者（59/724）已经服用或正在服用PrEP。结果表明，有风险的个体可能认为自己会从PrEP中受益。大多数人准确地感知到自己感染艾滋病毒的风险以及从PrEP中获得的益处。总体而言，他们似乎对PrEP的使用不太担心，态度普遍积极。有必要进一步调查，以了解为什么有风险的人没有意识到从PrEP中获得的益处。
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