Ko Nai-Ying, Wu Huei-Jiuan, Strong Carol, Li Chia-Wen, Ku Wen-Wei, Hsu Su-Ting
a Departments of Nursing, College of Medicine , National Cheng Kung University and Hospital , Tainan , Taiwan.
b Departments of Public Health , National Cheng Kung University , Tainan , Taiwan.
AIDS Care. 2018 Oct;30(10):1306-1310. doi: 10.1080/09540121.2018.1481195. Epub 2018 May 30.
Pre-exposure prophylaxis (PrEP) has proven to be effective in reducing the risk of HIV transmission in uninfected individuals who engaged in sexual activity with HIV-infected partners. Serodiscordant couples are the key targets of PrEP implementation. The study aimed to compare awareness of and willingness to use PrEP and anticipated condom use among 112 HIV-serodiscordant couples: 32 heterosexuals couples, 70 men who have sex with men (MSM) couples, and 10 people who inject drugs (PWID) couples. A cross-sectional study was conducted in an AIDS designated hospital in Taiwan. The PrEP survey for discordant couples included questions on awareness of non-occupational post-exposure prophylaxis (nPEP) and PrEP, attitudes toward PrEP, anticipated condom use if using PrEP, and sexual behaviors. Overall, 46.2% were aware of PrEP, only 33% were willing to take PrEP, and 44.6% would continue condom use if they were taking PrEP. Among the three key populations, MSM couples had the highest awareness of and willingness to use PrEP. Awareness of and willingness to use PrEP did not differ by HIV status, with moderate agreement (Cohen's Kappa coefficient: 0.56) between HIV-serodiscordant partners. Both HIV-serodiscordant partners' willingness to use PrEP was significantly associated with being MSM (adjusted odds ratio (AOR), 4.28 [1.28-14.30], p = 0.018), previous receipt of nPEP (AOR, 6.98 [1.23-39.65], p = 0.028), anticipated condom use (AOR, 0.14 [0.05-0.41], p < 0.001), and income ≥ NT$30,000 per month (AOR, 2.25 (0.99-5.04), p = 0.05). Policy makers need to consider the differences among key populations to scale up PrEP implementation. More efforts should be focused on improving awareness of and willingness to use PrEP among heterosexual and PWID serodiscordant couples to scale up PrEP implementation in Taiwan.
暴露前预防（PrEP）已被证明能有效降低未感染个体与感染艾滋病毒的伴侣发生性行为时感染艾滋病毒的风险。血清学不一致的伴侣是实施PrEP的关键目标人群。该研究旨在比较112对艾滋病毒血清学不一致的伴侣对PrEP的知晓率、使用意愿以及预期的避孕套使用情况，其中包括32对异性恋伴侣、70对男男性行为（MSM）伴侣以及10对注射吸毒者（PWID）伴侣。在台湾一家艾滋病指定医院开展了一项横断面研究。针对血清学不一致伴侣的PrEP调查涵盖了关于非职业性暴露后预防（nPEP）和PrEP的知晓情况、对PrEP的态度、若使用PrEP时预期的避孕套使用情况以及性行为等问题。总体而言，46.2%的人知晓PrEP，仅有33%的人愿意服用PrEP，并且44.6%的人表示若服用PrEP会继续使用避孕套。在这三个重点人群中，男男性行为伴侣对PrEP的知晓率和使用意愿最高。对PrEP的知晓率和使用意愿在艾滋病毒感染状况方面并无差异，血清学不一致的伴侣之间存在中度一致性（科恩kappa系数：0.56）。血清学不一致的伴侣双方使用PrEP的意愿均与男男性行为显著相关（调整后的优势比（AOR）为4.28 [1.28 - 14.30]，p = 0.018）、既往接受过nPEP（AOR为6.98 [1.23 - 39.65]，p = 0.028）、预期使用避孕套（AOR为0.14 [0.05 - 0.41]，p < 0.001）以及月收入≥新台币30,000元（AOR为2.25 [0.99 - 5.04]，p = 0.05）。政策制定者需要考虑重点人群之间的差异以扩大PrEP的实施范围。应更加努力提高异性恋和注射吸毒者血清学不一致伴侣对PrEP的知晓率和使用意愿，以在台湾扩大PrEP的实施。
