Jin Junyan, Sun Runsong, Mu Tingting, Jiang Taiyi, Dai Lili, Lu Hongyan, Ren Xianlong, Chen Jing, Ye Jingrong, Sun Lijun, Wu Hao, Zhang Tong, Zou Huachun, Su Bin
Beijing Key Laboratory for HIV/AIDS Research, Sino-French Joint Laboratory for Research on Humoral Immune Response to HIV Infection, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
School of Sociology, Beijing Normal University, Beijing, China.
Front Med (Lausanne). 2022 Jan 10;8:783626. doi: 10.3389/fmed.2021.783626. eCollection 2021.
The use of post-exposure prophylaxis (PEP) is effective in reducing HIV risk, but it is underused by men who have sex with men (MSM) due to certain psychological and sociostructural factors. This article assessed the awareness and use of PEP among MSM in an effort to increase the visibility and uptake of PEP among at-risk populations. We conducted a systematic literature search of the PubMed, Web of Science, PsycINFO, and Google Scholar electronic databases. Studies were screened for inclusion, and relevant data were abstracted, assessed for bias, and synthesized. Pooled effect estimates were calculated using random effects meta-analysis, meta-regression and subgroup analysis, and a qualitative review and risk of bias assessment were performed (PROSPERO, CRD42019123815). Twenty eligible studies involving 12,579 MSM were included in the meta-analysis. The pooled estimate of the proportions of MSM who were aware of PEP was modest at 59.9% (95% CI: 50.568.7) and that of MSM who previously used PEP was very low at 4.9% (95% CI: 2.49.8). PEP awareness showed no clear change over time, while PEP use significantly changed over time. Multiple factors affected awareness, including educational attainment, race/ethnicity, levels of HIV stigma, access to condoms, and so on. Many factors could potentially impede or facilitate the use of PEP, such as income, lack of PEP information, and partnership. We observed that PEP is an underused HIV prevention strategy among MSM and that once MSM become aware of PEP, the majority are willing to use it if they are supported appropriately in terms of a range of individual, social, and structural barriers. : http://www.cdr.york.ac.uk/prospero, PROSPERO [CRD42019123815].
暴露后预防（PEP）的使用在降低感染艾滋病毒风险方面是有效的，但由于某些心理和社会结构因素，男男性行为者（MSM）对其使用不足。本文评估了男男性行为者对暴露后预防的知晓情况和使用情况，以期提高高危人群对暴露后预防的认知度和使用率。我们对PubMed、科学网、PsycINFO和谷歌学术电子数据库进行了系统的文献检索。对研究进行筛选以确定纳入研究，提取相关数据，评估偏倚并进行综合分析。使用随机效应荟萃分析、荟萃回归和亚组分析计算合并效应估计值，并进行定性综述和偏倚风险评估（国际前瞻性系统评价注册库，CRD42019123815）。荟萃分析纳入了20项涉及12,579名男男性行为者的合格研究。知晓暴露后预防措施的男男性行为者比例的合并估计值为中等水平，为59.9%（95%置信区间：50.568.7），而之前使用过暴露后预防措施的男男性行为者比例非常低，为4.9%（95%置信区间：2.49.8）。暴露后预防的知晓率随时间没有明显变化，而暴露后预防的使用率随时间有显著变化。多种因素影响知晓情况，包括教育程度、种族/民族、对艾滋病毒的污名化程度、获取避孕套的情况等。许多因素可能会阻碍或促进暴露后预防的使用，如收入、缺乏暴露后预防信息以及伴侣关系等。我们观察到，暴露后预防在男男性行为者中是一种未得到充分利用的艾滋病毒预防策略，而且一旦男男性行为者知晓暴露后预防措施，如果在一系列个人、社会和结构障碍方面得到适当支持，大多数人愿意使用它。：http://www.cdr.york.ac.uk/prospero，国际前瞻性系统评价注册库[CRD42019123815]
