National Health Commission Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.
JMIR Public Health Surveill. 2021 Mar 11;7(3):e24234. doi: 10.2196/24234.
Nonoccupational postexposure prophylaxis (nPEP) is an effective HIV biomedical prevention strategy. The research and use of nPEP are mainly concentrated in the developed world, while little is known about the knowledge, attitudes, and practices of nPEP among HIV medical care providers in developing countries.
We aimed to assess the nPEP knowledge and prescribing practice among HIV medical care providers in mainland China.
HIV medical care providers were recruited in China during May and June 2019 through an online survey regarding nPEP-related knowledge, attitudes, and clinical prescription experiences. Multivariable logistic regression was performed to identify factors associated with prescribing nPEP among HIV medical care providers.
A total of 777 eligible participants participated in this study from 133 cities in 31 provinces in China. Of the participants, 60.2% (468/777) were unfamiliar with nPEP and only 53.3% (414/777) of participants ever prescribed nPEP. HIV care providers who worked in a specialized infectious disease hospital (vs general hospital, adjusted odds ratio [aOR] 2.49; 95% CI 1.85-3.37), had practiced for 6-10 years (vs 5 or fewer years, aOR 3.28; 95% CI 2.23-4.80), had practiced for 11 years or more (vs 5 or fewer years, aOR 3.75; 95% CI 2.59-5.45), and had previously prescribed occupational PEP (oPEP, aOR 4.90; 95% CI 3.29-7.29) had a significantly positive association with prescribing nPEP. However, unfamiliarity with nPEP (aOR 0.08; 95% CI 0.05-0.11), believing nPEP may promote HIV high-risk behavior (aOR 0.53; 95% CI 0.36-0.77) or result in HIV drug resistance (aOR 0.53; 95% CI 0.36-0.77) among key populations, and self-reported having no written oPEP guideline in place (aOR 0.53; 95% CI 0.35-0.79) were negatively associated with nPEP prescription behavior.
HIV medical care providers have insufficient nPEP knowledge and an inadequate proportion of prescribing, which may impede the scale-up of nPEP services to curb HIV acquisition. The implementation of tailored nPEP training or retraining to HIV medical care providers would improve this situation.
非职业性暴露后预防（nPEP）是一种有效的艾滋病生物医学预防策略。nPEP 的研究和使用主要集中在发达国家，而对于发展中国家的艾滋病医疗服务提供者对 nPEP 的了解、态度和实践知之甚少。
我们旨在评估中国大陆艾滋病医疗服务提供者对 nPEP 的知识和处方实践。
2019 年 5 月至 6 月，通过在线调查，在中国招募了艾滋病医疗服务提供者，调查内容涉及 nPEP 相关知识、态度和临床处方经验。采用多变量逻辑回归分析确定与艾滋病医疗服务提供者开具 nPEP 相关的因素。
共有 777 名来自中国 31 个省 133 个城市的合格参与者参加了这项研究。在参与者中，60.2%（468/777）不熟悉 nPEP，只有 53.3%（414/777）的参与者曾开具过 nPEP。在专门的传染病医院（vs 综合医院，调整后的优势比[aOR]2.49；95%CI 1.85-3.37）工作、工作 6-10 年（vs 5 年或更短，aOR 3.28；95%CI 2.23-4.80）、工作 11 年或以上（vs 5 年或更短，aOR 3.75；95%CI 2.59-5.45）和以前开具过职业性 PEP（oPEP，aOR 4.90；95%CI 3.29-7.29）的艾滋病医疗服务提供者与开具 nPEP 有显著的正相关。然而，不熟悉 nPEP（aOR 0.08；95%CI 0.05-0.11）、认为 nPEP 可能会促进高危 HIV 行为（aOR 0.53；95%CI 0.36-0.77）或导致 HIV 耐药（aOR 0.53；95%CI 0.36-0.77）的关键人群，以及自我报告没有书面的 oPEP 指南（aOR 0.53；95%CI 0.35-0.79）与 nPEP 处方行为呈负相关。
艾滋病医疗服务提供者对 nPEP 的知识不足，开具处方的比例也不足，这可能会阻碍 nPEP 服务的扩大，以遏制艾滋病毒的传播。对艾滋病医疗服务提供者进行有针对性的 nPEP 培训或再培训，将改善这种情况。
