了解中国男男性行为者使用口服暴露前预防（PrEP）进行 HIV 预防的意愿。
Understanding willingness to use oral pre-exposure prophylaxis for HIV prevention among men who have sex with men in China.
机构信息
Wuhan Centers for Disease Prevention & Control, Wuhan, Hubei, China.
Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia.
出版信息
PLoS One. 2018 Jun 21;13(6):e0199525. doi: 10.1371/journal.pone.0199525. eCollection 2018.
BACKGROUND
Oral pre-exposure prophylaxis (PrEP) is recommended as an additional prevention choice for men who have sex with men (MSM) at substantial risk of HIV. The aim of this study was to evaluate the extent, and reasons, for MSM's willingness to use oral PrEP in Wuhan and Shanghai, China.
METHODS
Between May and December 2015, a cross-sectional survey was conducted among 487 MSM recruited through snowball sampling in physical locations frequented by MSM and through social media applications. Exploratory factor analysis was used to group reasons for being willing or not willing to use PrEP. Chi-square tests were used to explore bivariate associations between groupings of reasons for being willing or unwilling to use PrEP, and key sociodemographic and sexual-behavioral characteristics of MSM.
RESULTS
Overall, 71.3% of respondents were willing to use PrEP. The most commonly reported reasons for being willing to use PrEP were preventing HIV infection (91.6%), taking responsibility for own sexual health (72.6%) and protecting family members from harm (59.4%). The main reasons for being unwilling to use PrEP were being worried about side effects (72.9%), the necessity of taking PrEP for long periods of time (54.3%) and cost (40.4%). Individual characteristics that influenced the type of reasons given for being willing or unwilling to use PrEP included being married to a woman, having a regular sex partner, rates of condom use with regular and casual sex partners, and the number of casual sex partners.
CONCLUSION
The introduction of PrEP in China could benefit from promotion campaigns that emphasize its role in preventing HIV infection, in taking responsibility for own sexual health, and in protecting family members from potential harm. To reduce uptake barriers, it will be essential to provide accurate information to potential PrEP users about the mild and short-term nature of side effects, and the possibility of taking PrEP only during particular periods of life when the risk of HIV exposure might be highest.
背景
口腔暴露前预防（PrEP）被推荐作为感染 HIV 风险较高的男男性行为者（MSM）的另一种预防选择。本研究旨在评估中国武汉和上海 MSM 对使用口服 PrEP 的意愿程度及其原因。
方法
2015 年 5 月至 12 月，采用滚雪球抽样法在 MSM 常去的实体场所和社交媒体应用程序中招募了 487 名 MSM 进行横断面调查。采用探索性因子分析将愿意或不愿意使用 PrEP 的原因进行分组。采用卡方检验探索愿意或不愿意使用 PrEP 的原因分组与 MSM 的关键社会人口学和性行为特征之间的双变量关联。
结果
总体而言，71.3%的受访者愿意使用 PrEP。愿意使用 PrEP 的最常见原因是预防 HIV 感染（91.6%）、对自身性健康负责（72.6%）和保护家庭成员免受伤害（59.4%）。不愿意使用 PrEP 的主要原因是担心副作用（72.9%）、需要长期服用 PrEP（54.3%）和费用（40.4%）。影响愿意或不愿意使用 PrEP 的原因的个体特征包括与女性结婚、有固定性伴侣、与固定性伴侣和偶尔性伴侣使用安全套的比例，以及偶尔性伴侣的数量。
结论
在中国引入 PrEP 可以受益于宣传活动，强调其在预防 HIV 感染、对自身性健康负责以及保护家庭成员免受潜在伤害方面的作用。为了减少使用障碍，向潜在的 PrEP 用户提供关于副作用轻微且短期、仅在 HIV 暴露风险最高的特定时期使用 PrEP 的可能性的准确信息至关重要。
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