Department of Internal Medicine, Section of Infectious Diseases, 12228Yale School of Medicine, New Haven, CT, USA.
Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA.
Int J STD AIDS. 2022 Aug;33(9):821-828. doi: 10.1177/09564624221106535. Epub 2022 Jun 30.
Pre-exposure prophylaxis (PrEP) is a valuable HIV prevention strategy, particularly among men who have sex with men (MSM); however, PrEP uptake is below the threshold needed to curb the HIV epidemic among this group, especially in settings like Malaysia, where same-sex sexual behavior is illegal.
A sample of 355 participants completed an online survey between June and July 2020, recruited through geosocial networking apps for MSM and social networking websites (e.g. Facebook). We used descriptive and multivariable analyses to examine correlates of PrEP use within this population.
The sample was predominantly Malay (53.5%), had monthly incomes greater than RM 3000 (USD 730) (52.7%), and a tertiary level of education (84.5%). About 80% of participants heard of PrEP prior to the survey, with significantly less (18.3%) having ever taken PrEP. In the adjusted multivariable logistic model, using drugs before or during sexual intercourse ("chemsex") (AOR: 3.37; 95% CI: 1.44-7.89), being diagnosed with a sexually transmitted infection in the last 12 months (AOR: 2.08; 95% CI: 1.13-3.85), HIV testing in the previous 6 months (AOR: 3.23; 95% CI: 1.74-5.99), and disclosure of sexual orientation (AOR: 1.85; 95% CI: 1.02-3.34) were associated with having taken PrEP in the past.
This study revealed that PrEP use among Malaysian MSM is relatively low, despite high awareness, and is associated with healthcare engagement and high-risk behaviors. These results highlight the need to tailor outreach activities for individuals at increased risk for HIV and those disengaged with the health system.
暴露前预防（PrEP）是一种有价值的艾滋病毒预防策略，特别是在男男性行为者（MSM）中；然而，PrEP 的采用率低于遏制该人群中艾滋病毒流行所需的阈值，特别是在马来西亚等同性性行为非法的地方。
在 2020 年 6 月至 7 月期间，通过面向 MSM 的地理社交网络应用程序和社交网络网站（如 Facebook）招募了 355 名参与者完成了在线调查。我们使用描述性和多变量分析来研究该人群中 PrEP 使用的相关性。
该样本主要是马来人（53.5%），月收入超过 3000 林吉特（730 美元）（52.7%），并接受过高等教育（84.5%）。大约 80%的参与者在调查前听说过 PrEP，而曾经服用过 PrEP 的人明显较少（18.3%）。在调整后的多变量逻辑模型中，在性交前或期间使用毒品（“化学性交”）（AOR：3.37；95%CI：1.44-7.89）、在过去 12 个月内被诊断出患有性传播感染（AOR：2.08；95%CI：1.13-3.85）、在过去 6 个月内进行 HIV 检测（AOR：3.23；95%CI：1.74-5.99）和性取向披露（AOR：1.85；95%CI：1.02-3.34）与过去曾服用过 PrEP 相关。
这项研究表明，尽管马来西亚 MSM 对 PrEP 的认识度较高，但 PrEP 的使用相对较低，且与医疗保健参与度和高危行为相关。这些结果强调了需要针对感染艾滋病毒风险较高和与卫生系统脱节的个人开展外展活动。
