De Montfort University, Leicester, UK.
University of Coimbra, Coimbra, Portugal.
HIV Med. 2019 Jan;20(1):11-18. doi: 10.1111/hiv.12667. Epub 2018 Aug 30.
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool for high-risk men who have sex with men (MSM). However, acceptability and uptake have been variable. This study explored the factors that predict PrEP acceptability in MSM in Leicester, where HIV prevalence is double the national average.
A total of 191 HIV-negative MSM completed a cross-sectional survey. Participants provided demographic information, and completed measures of HIV knowledge, perceived HIV risk, engagement in sexual risk behaviour, acquisition of a sexually transmitted infection (STI) in the last 12 months, frequency of HIV testing and PrEP acceptability.
Kruskal-Wallis tests showed statistically significant effects of sexual orientation, education level and income, respectively, on HIV knowledge. Gay-identified individuals possessed greater HIV knowledge than bisexuals. Respondents with General Certificate of Secondary Education (GCSE)-level education had significantly less HIV knowledge than those educated to postgraduate level. Respondents with income of < £10 000 possessed significantly less HIV knowledge than higher income groups. Structural equation modelling showed that the relationship between HIV knowledge and PrEP acceptability was mediated by perceived HIV risk, engagement in sexual risk behaviour, acquisition of an STI in the past 12 months and frequency of HIV testing.
The results reveal socio-economic inequalities in HIV knowledge and HIV testing, and suggest that MSM who have high levels of HIV knowledge and perceived HIV risk and who regularly test for HIV are most likely to endorse PrEP as personally beneficial. HIV knowledge and accurate risk appraisal should be promoted in MSM. The HIV testing context constitutes an ideal context for promoting PrEP to high-risk MSM.
暴露前预防（PrEP）是一种针对男男性行为者（MSM）的有效艾滋病毒预防工具。然而，其可接受性和使用率存在差异。本研究旨在探索莱斯特（Leicester）地区 MSM 人群中影响 PrEP 可接受性的因素，该地区的艾滋病毒感染率是全国平均水平的两倍。
共 191 名 HIV 阴性的 MSM 完成了一项横断面调查。参与者提供了人口统计学信息，并完成了 HIV 知识、感知 HIV 风险、性行为风险行为、过去 12 个月获得性传播感染（STI）、HIV 检测频率和 PrEP 可接受性的测量。
Kruskal-Wallis 检验显示，性取向、教育水平和收入分别对 HIV 知识具有统计学显著影响。同性恋者比双性恋者具有更多的 HIV 知识。具有普通中等教育（GCSE）水平教育的受访者比具有研究生水平教育的受访者 HIV 知识明显较少。收入低于 £10000 的受访者的 HIV 知识明显少于高收入群体。结构方程模型显示，HIV 知识和 PrEP 可接受性之间的关系受感知 HIV 风险、性行为风险行为、过去 12 个月中获得性传播感染和 HIV 检测频率的影响。
研究结果揭示了 HIV 知识和 HIV 检测方面的社会经济不平等，并表明 HIV 知识和感知 HIV 风险水平较高、且定期进行 HIV 检测的 MSM 最有可能认可 PrEP 对个人有益。应在 MSM 中推广 HIV 知识和准确的风险评估。HIV 检测环境是向高危 MSM 推广 PrEP 的理想环境。
