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[2015年武汉市301名男男性行为者暴露前预防用药的意愿及影响因素]

[Willingness and influencing factors of using pre-exposure prophylaxis among 301 men have sex with men in Wuhan city, 2015].

作者信息

Xie P Y, Wang X, Liu P L, Tan X D, Zhou W

机构信息

School of Health Sciences, Wuhan University, Wuhan 430000, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Nov 6;51(11):1001-1006. doi: 10.3760/cma.j.issn.0253-9624.2017.11.009.

Abstract

To understand willingness and influencing factors of using pre-exposure prophylaxis (Pr-EP) among men who have sex with men (MSM). Snow ball sampling was employed to recruit MSM in the social spaces (like bars and bathrooms) with focused activities by MSM and internet (QQ and Wechat) in Wuhan between August and November, 2015. 304 MSM were considered eligible when they were self-identified MSM and has had sex with men in the previous 12 months, over the age of 18 and have full civil liability. On-site and online questionnaire surveys were conducted by self-designed questionnaires to collect information including demographic characteristics, sexual risks and practices, awareness of PrEP, and willingness to use PrEP. A total of 301 qualified questionnaires were obtained. Multivariate logistic regression models were constructed to identify factors associated with willingness to use Pr-EP. The mean age of surveyed MSM were (27.51±8.31) years, between18-61. 149 on-site survey, online were152; 131 MSM have regular homosexual partners, 170 MSM have not regular homosexual partners. Only 17.28% (52/301) had heard of Pr-EP before this survey, 18.32% (24/130) had heard of Pr-EP among those who had regular homosexual partners and those who had not accounted for 16.47% (28/170). 74.42% (224/301) had willingness to use Pr-EP after they knew Pr-EP was safe and effective through the survey. The proportion among those who had regular homosexual partners was 74.05%(74), and the proportion among those who had not was 74.71% (127); Among those who had regular homosexual partners, results suggested that those who were married/cohabiting were more likely to report a willingness to use PrEP compared to unmarried/divorced or widowed (5.60), compared with homosexual, heterosexuality was associated with decreased odds of willingness to use Pr-EP ( 0.22), compared with HIV status of sexual partner was negative or uncertain, positive infection status was associated with increased odds of willingness to use (7.52). Compared with MSM who have not regular homosexual partners, those who were married/cohabiting were more likely to report a willingness to use PrEP compared to unmarried/divorced or widowed (9.09), compared with those who think they have risk of infection, those who do not think they have risk of infection was associated with decreased odds of willingness to use Pr-EP ( 0.30), compared with those with a high frequency to seek sexual partners, those not often to seek was associated with decreased odds of willingness to use Pr-EP ( 0.27). All above values were<0.05. The awareness rate of Pr-EP among MSM in Wuhan is low in 2015, but the willingness to use Pr-EP could get a considerable increase after introduction. It is considered that promotion of Pr-EP is feasible in China, and there are different influencing factors for the willingness between two MSM subgroups (having regular homosexual partners and having no regular homosexual partners).

摘要

了解男男性行为者(MSM)使用暴露前预防(PrEP)的意愿及影响因素。2015年8月至11月,采用雪球抽样法,在武汉市男男性行为者聚集的社交场所(如酒吧、浴室)以及通过网络(QQ和微信),针对有针对性活动的男男性行为者进行招募。304名男男性行为者符合条件,他们自我认定为男男性行为者,在过去12个月内与男性发生过性行为,年龄在18岁以上且具有完全民事行为能力。通过自行设计的问卷进行现场和在线问卷调查,收集包括人口统计学特征、性风险及行为、对PrEP的知晓情况以及使用PrEP的意愿等信息。共获得301份合格问卷。构建多因素logistic回归模型以确定与使用PrEP意愿相关的因素。被调查男男性行为者的平均年龄为(27.51±8.31)岁,年龄范围在18 - 61岁。现场调查149人,在线调查152人;131名男男性行为者有固定同性伴侣,170名男男性行为者无固定同性伴侣。在本次调查前,仅有17.28%(52/301)听说过PrEP,在有固定同性伴侣的人群中,18.32%(24/130)听说过PrEP,在无固定同性伴侣的人群中这一比例为16.47%(28/170)。通过调查得知PrEP安全有效后,74.42%(224/301)愿意使用PrEP。有固定同性伴侣的人群中这一比例为74.05%(74),无固定同性伴侣的人群中这一比例为74.71%(127);在有固定同性伴侣的人群中,结果显示,与未婚/离异或丧偶者相比,已婚/同居者更有可能表示愿意使用PrEP(5.60),与同性恋者相比,异性恋者使用PrEP意愿的几率降低(0.22),与性伴侣HIV状态为阴性或不确定相比,阳性感染状态与使用意愿增加相关(7.52)。与无固定同性伴侣的男男性行为者相比,已婚/同居者与未婚/离异或丧偶者相比更有可能表示愿意使用PrEP(9.09),与认为自己有感染风险的人相比,不认为自己有感染风险的人使用PrEP意愿的几率降低(0.30),与寻求性伴侣频率高的人相比,不常寻求性伴侣的人使用PrEP意愿的几率降低(0.27)。以上所有值均<0.05。2015年武汉市男男性行为者对PrEP的知晓率较低,但在介绍后使用PrEP的意愿有显著提高。认为在中国推广PrEP是可行的,且在两个男男性行为者亚组(有固定同性伴侣和无固定同性伴侣)中使用意愿存在不同的影响因素。

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