From the Dalla Lana School of Public Health, University of Toronto, Toronto.
Faculty of Medicine, University of British Columbia, Vancouver.
Sex Transm Dis. 2020 Apr;47(4):224-231. doi: 10.1097/OLQ.0000000000001130.
We assessed the acceptability of doxycycline-based syphilis pre-exposure and post-exposure prophylaxis (PrEP/PEP) as well as human immunodeficiency virus (HIV) PrEP/PEP in gay, bisexual, and other men who have sex with men (gbMSM).
We recruited gbMSM from Toronto and Vancouver sexually transmitted infection (STI) clinics during routine visits from June 2018 to August 2018. We analyzed data using descriptive statistics and constructed multivariable logistic regression models for willingness to use syphilis and HIV PrEP and PEP respectively.
Among 424 participants (56.4% Toronto, 43.6% Vancouver), median (interquartile range [IQR]) age was 31.0 years (26.0-39.0 years), 61.7% had completed postsecondary education and 54.4% were white. Median (IQR) number of male partners in the past 6 months was 6.0 (3.0-13.0), and 18.2% had 1 or more prior syphilis diagnosis. 60.1%/44.1% indicated willingness to use syphilis PEP/PrEP; 36.6% were unwilling to use either. Among HIV-negative participants, 74.0% and 75.2% were willing to use HIV PrEP and PEP, respectively. Most participants were familiar with antibiotic resistance (89.0%) and agreed that syphilis rates are rising in Canada (68.2%), but only 55.4% believed they were at risk for syphilis. Agreement with the latter statement was associated with willingness to use syphilis PrEP (adjusted odds ratio [aOR], 1.6; 95% confidence interval [95%CI], 1.0-2.5), as was previous/existing HIV PrEP use (aOR, 2.2; 95% CI, 1.1-4.3) and being "very concerned" about STI acquisition (aOR, 1.9; 95% CI, 1.0-3.4). Odds of being willing to use syphilis PEP were higher in Toronto versus Vancouver (aOR, 2.0; 95% CI, 1.2-3.4) and increased with the number of different STIs previously diagnosed (aOR, 1.4; 95% CI, 1.2,1.7).
There is considerable interest in syphilis PrEP/PEP in gbMSM attending Toronto/Vancouver STI clinics.
我们评估了基于强力霉素的梅毒暴露前和暴露后预防（PrEP/PEP）以及人类免疫缺陷病毒（HIV）PrEP/PEP 在男同性恋、双性恋和其他与男性发生性关系的男性（gbMSM）中的可接受性。
我们在 2018 年 6 月至 2018 年 8 月期间从多伦多和温哥华性传播感染（STI）诊所招募了 gbMSM 参与者。我们使用描述性统计数据和构建多变量逻辑回归模型分别分析了愿意使用梅毒和 HIV PrEP/PEP 的意愿数据。
在 424 名参与者中（56.4%来自多伦多，43.6%来自温哥华），中位（四分位距 [IQR]）年龄为 31.0 岁（26.0-39.0 岁），61.7%完成了中学后教育，54.4%为白人。过去 6 个月中，中位（IQR）男性伴侣数为 6.0（3.0-13.0），18.2%有 1 个或多个既往梅毒诊断。60.1%/44.1%表示愿意使用梅毒 PEP/PrEP；36.6%表示不愿意使用任何一种。在 HIV 阴性参与者中，74.0%和 75.2%分别愿意使用 HIV PrEP 和 PEP。大多数参与者熟悉抗生素耐药性（89.0%），并同意梅毒在加拿大的发病率正在上升（68.2%），但只有 55.4%认为自己有感染梅毒的风险。对后者的认同与使用梅毒 PrEP 的意愿有关（调整后的优势比[aOR]，1.6；95%置信区间[95%CI]，1.0-2.5），既往/现有的 HIV PrEP 使用（aOR，2.2；95%CI，1.1-4.3）和对性传播感染（STI）的“非常关注”（aOR，1.9；95%CI，1.0-3.4）也是如此。与温哥华相比，在多伦多愿意使用梅毒 PEP 的可能性更高（aOR，2.0；95%CI，1.2-3.4），并且随着以前诊断出的不同 STI 数量的增加而增加（aOR，1.4；95%CI，1.2,1.7）。
在参加多伦多/温哥华性传播感染（STI）诊所的 gbMSM 中，对梅毒 PrEP/PEP 有很大的兴趣。
