Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.
Australian Federation of AIDS Organisations, Sydney, Australia.
J Acquir Immune Defic Syndr. 2021 Apr 1;86(4):430-435. doi: 10.1097/QAI.0000000000002572.
BACKGROUND: We assessed willingness to use HIV pre-exposure prophylaxis (PrEP) and current PrEP use among gay and bisexual men (GBM) in Australia. METHODS: National, online cross-sectional surveys of GBM were conducted in 2013, 2015, 2017, and 2019. Willingness to use PrEP was measured on a previously validated scale. Trends and associations with key measures were analyzed using multivariate logistic regression. RESULTS: During 2013-2019, 4908 surveys were completed. Among HIV-negative and untested men not currently using PrEP, willingness to use PrEP increased from 23.0% in 2013 to 36.5% in 2017 (P < 0.001) but then plateaued at 32% in 2019 (P = 0.13). The proportion of current PrEP users increased significantly from 2.5% in 2015 to 38.5% in 2019 (P < 0.001). In 2019, factors independently associated with being a current PrEP user (compared with non-PrEP users who were willing to use PrEP) included having subsidized health care (Medicare), knowing HIV-positive people, being recently diagnosed with an STI other than HIV, having higher numbers of recent male sexual partners, recent condomless sex with casual and regular partners, and frequent PrEP sorting. CONCLUSION: Willingness to use PrEP has plateaued as its use has rapidly increased among GBM in Australia. PrEP use is concentrated among more sexually active men with access to subsidized health care. Free or low cost access schemes may facilitate broader access among GBM who want or need PrEP but lack access to subsidized health care.
背景：我们评估了澳大利亚男同性恋和双性恋者（GBM）使用 HIV 暴露前预防（PrEP）的意愿和当前 PrEP 的使用情况。
方法：2013 年、2015 年、2017 年和 2019 年，对 GBM 进行了全国性的在线横断面调查。使用先前验证过的量表测量使用 PrEP 的意愿。使用多变量逻辑回归分析趋势和与关键指标的关联。
结果：在 2013 年至 2019 年期间，完成了 4908 项调查。在 HIV 阴性且未经检测且目前未使用 PrEP 的男性中，愿意使用 PrEP 的比例从 2013 年的 23.0%增加到 2017 年的 36.5%（P<0.001），但随后在 2019 年稳定在 32%（P=0.13）。当前 PrEP 用户的比例从 2015 年的 2.5%显著增加到 2019 年的 38.5%（P<0.001）。在 2019 年，与非 PrEP 用户（愿意使用 PrEP）相比，当前 PrEP 用户的独立相关因素包括享受补贴医疗保健（医疗保险）、认识 HIV 阳性者、最近被诊断患有除 HIV 以外的性传播感染、近期男性性伴侣数量较多、与偶然和固定伴侣发生无保护性行为以及频繁进行 PrEP 分类。
结论：随着澳大利亚 GBM 使用 PrEP 的快速增加，使用 PrEP 的意愿已经趋于平稳。PrEP 的使用集中在那些有补贴医疗保健的、性活跃程度更高的男性中。免费或低价获得方案可能会促进更多希望或需要 PrEP 但无法获得补贴医疗保健的 GBM 获得 PrEP。
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