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[山东省男男性行为人群中艾滋病病毒暴露前预防和暴露后预防的接受情况及相关因素]

[Acceptance of pre-exposure prophylaxis and post-exposure prophylaxis against HIV and related factors in men who have sex with men in Shandong Province].

作者信息

Zhang X N, Yan K, You X D, Li J H, Zhang N, Wang G Y, Liao M Z, Ma W

机构信息

Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Ji'nan 250012, China.

Department of AIDS/STD Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji'nan 250014, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2023 Sep 10;44(9):1352-1357. doi: 10.3760/cma.j.cn112338-20230202-00052.

Abstract

To understand the use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and related factors in men who have sex with men (MSM) in Shandong Province, and provide reference for the promotion of PrEP and PEP in MSM. From April to July in 2022, MSM were recruited from 7 sentinel surveillance sites in Shandong Province for a questionnaire survey, and the sample size of each city site was 400. The information about sociodemographic characteristics, sexual behaviors, the uses of PrEP and PEP and others were collected from the MSM, and blood samples were collected from them for HIV and syphilis testing. A total of 2 815 MSM were investigated, the majority of them were aged less than 30 years (55.7%, 1 569/2 815), unmarried (68.6%, 1 931/2 815) and had education background of college and above (56.5%, 1 590/2 815). Only 9.2% (258/2 815) had used PrEP and 10.8% (305/2 815) had used PEP. Multivariate logistic regression showed that factors associated with high likelihood of PrEP use in MSM included age ≤30 years (a=4.04, 95%:1.25-13.01), self-perceived lower risk of HIV infection (a=1.76, 95%:1.16-2.68), group sex and commercial sex in the past six months (a=1.51, 95%: 1.10-2.09; a=1.69, 95%: 1.16-2.47), new-type drug use (a=1.53, 95%: 1.11-2.11), receiving peer education (a=1.56, 95%: 1.03-2.37), other people using PrEP (a=3.29, 95%: 2.48-4.36), and being HIV negative (a=8.40, 95%:1.12-63.12). Factor associated with low likelihood of PrEP use in MSM was anal sex with casual partner (a=0.67, 95%:0.49-0.90). Factors associated with high likelihood of PEP use in MSM included age under 50 years (≤30 years old: a=2.41, 95%:1.02-5.69; 31-49 years old: a=3.33, 95%1.42-7.85), no self-perceived risk for HIV infection (a=1.87, 95%:1.12-3.11), group sex in the past six months (a=1.68, 95%:1.23-2.29), new-type drug use (a=3.86, 95%:2.94-5.07) and receiving no peer education (a=1.54, 95%:1.12-2.12). In Shandong, a higher proportion of MSM used PrEP and PEP. Peer education and self-perceived HIV infection risk education should be strengthened to increase the rates of PrEP and PEP use in MSM.

摘要

为了解山东省男男性行为者(MSM)中暴露前预防(PrEP)和暴露后预防(PEP)的使用情况及相关因素,为在MSM中推广PrEP和PEP提供参考。2022年4月至7月,从山东省7个哨点监测点招募MSM进行问卷调查,每个城市监测点的样本量为400。收集MSM的社会人口学特征、性行为、PrEP和PEP使用情况等信息,并采集血样进行HIV和梅毒检测。共调查了2815名MSM,其中大多数年龄小于30岁(55.7%,1569/2815)、未婚(68.6%,1931/2815)且具有大专及以上学历(56.5%,1590/2815)。仅9.2%(258/2815)的人使用过PrEP,10.8%(305/2815)的人使用过PEP。多因素logistic回归显示,MSM中与PrEP高使用可能性相关的因素包括年龄≤30岁(a=4.04,95%CI:1.25-13.01))、自我感知HIV感染风险较低(a=1.76,95%CI:1.16-2.68)、过去六个月有群交和商业性行为(a=1.51,95%CI:1.10-2.09;a=1.69,95%CI:1.16-2.47)、使用新型毒品(a=1.53,95%CI:1.11-2.11)、接受同伴教育(a=1.56,95%CI:1.03-2.37)、其他人使用PrEP(a=3.29,95%CI:2.48-4.36)以及HIV阴性(a=8.40,95%CI:1.12-63.12)。MSM中与PrEP低使用可能性相关的因素是与临时伴侣发生肛交(a=0.67,95%CI:0.49-0.90)。MSM中与PEP高使用可能性相关的因素包括年龄小于50岁(≤30岁:a=2.41,95%CI:1.02-5.69;31-49岁:a=3.33,95%CI:1.42-7.85)、自我感知无HIV感染风险(a=1.87,95%CI:1.12-3.11)、过去六个月有群交行为(a=1.68,95%CI:1.23-2.29)、使用新型毒品(a=3.86,95%CI:2.94-5.07)以及未接受同伴教育(a=1.54,95%CI:1.12-2.12)。在山东,MSM中PrEP和PEP的使用比例较高。应加强同伴教育和自我感知HIV感染风险教育,以提高MSM中PrEP和PEP的使用率。

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