Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.
J Int AIDS Soc. 2019 Feb;22(2):e25242. doi: 10.1002/jia2.25242.
HIV incidence among men who have sex with men (MSM) is high in China. Pre-exposure prophylaxis (PrEP) is a promising mean to prevent HIV transmission but it is not widely available in China. We conducted a large Internet-based online survey to assess the willingness of Chinese MSM to take PrEP and associated factors to their uptake preferences.
Between 19 January and 6 February, 2017, 4581 MSM aged over 15 years were recruited via a social networking app to take an online PrEP survey. HIV status at the time of the survey being conducted was not one of recruitment criteria. Participants were asked if they had heard of PrEP, if they had concerns about PrEP, and if they would be ready to uptake PrEP should it be provided. When asked if participants were willing to take PrEP, they were asked to select from the following responses: "definitely not," "probably not," "not sure," "probably yes," and "definitely yes." In the final analysis, we grouped these five-level Likert scale responses into three-level responses as "definitely yes," "probably yes," and "no (definitely not/probably not/not sure)." Descriptive analysis and multinomial logistic regressions were conducted to assess the associations of PrEP adoption readiness and uptake concerns with HIV risk behaviours and demographic characteristics.
MSM from 33 geographical regions of China participated in the survey. The majority were younger than 25 (65.2%) and had attended college (68.6%). HIV prevalence was high (6.8%) and 43.3% reported a history of unprotected anal sex. Only 22.4% of participants had heard of PrEP. When asked if they would uptake PrEP, 26.0% said "definitely yes," 49.6% were "probably yes," and 24.4% said "no." PrEP adoption readiness was associated with having previously heard of PrEP and expressing concerns about accessibility and cost. Worries about side effects, low perceived HIV risk, preference for condoms, and never having received HIV testing were negatively associated with PrEP uptake willingness.
Young and well-educated Chinese MSM reported a low willingness to uptake PrEP despite being high-risk for HIV. Effective education, especially through online mediums, will be critical to optimize this group's PrEP uptake.
中国男男性行为者（MSM）中的 HIV 发病率很高。暴露前预防（PrEP）是预防 HIV 传播的一种很有前途的方法，但在中国尚未广泛应用。我们进行了一项大型的基于互联网的在线调查，以评估中国 MSM 对 PrEP 的接受意愿以及与他们接受意愿相关的因素。
2017 年 1 月 19 日至 2 月 6 日，通过社交网络应用程序招募了 4581 名年龄在 15 岁以上的 MSM 参与在线 PrEP 调查。在招募时，HIV 检测结果不作为招募标准。参与者被问及是否听说过 PrEP，对 PrEP 的关注，以及如果提供 PrEP 是否愿意接受。当被问及是否愿意接受 PrEP 时，他们被要求从以下回答中选择：“绝对不会”“可能不会”“不确定”“可能会”和“绝对会”。在最终分析中，我们将这五个级别的李克特量表反应分为三个级别的反应，即“绝对会”“可能会”和“不会（绝对不会/可能不会/不确定）”。描述性分析和多项逻辑回归用于评估 PrEP 采用准备情况和采用顾虑与 HIV 风险行为和人口统计学特征的相关性。
来自中国 33 个地理区域的 MSM 参与了这项调查。大多数参与者年龄在 25 岁以下（65.2%），并接受过大学教育（68.6%）。HIV 流行率很高（6.8%），43.3%的人报告有过无保护的肛交史。只有 22.4%的参与者听说过 PrEP。当被问及是否会接受 PrEP 时，26.0%的人表示“绝对会”，49.6%的人表示“可能会”，24.4%的人表示“不会”。PrEP 采用准备情况与以前听说过 PrEP 以及对获取途径和费用的关注有关。对副作用、低 HIV 风险认知、对避孕套的偏好以及从未接受过 HIV 检测的担忧与 PrEP 采用意愿呈负相关。
尽管中国的 MSM 存在较高的 HIV 感染风险，但他们对接种 PrEP 的意愿较低。有效的教育，尤其是通过在线媒体，对于优化这一群体对 PrEP 的接受意愿至关重要。
