Xia D Y, Su X L, Liu G W, Ren X L, Wang J, Li G Y, Chen J, Xu C H, Lu H Y
Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2023 Sep 10;44(9):1390-1396. doi: 10.3760/cma.j.cn112338-20230308-00133.
To understand the incidence of HIV infection, high risk behaviors and pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) utilization in men who have sex with men (MSM) in Beijing. Sample size was estimated to be 1 227 persons and 207 person year respectively in the survey and the cohort by using Epi Info 7.0 software. Using convenient sampling method, MSM were recruited by using Wechat app. Questionnaire was completed online to collect the information about demographic characteristics, high risk behavior, and utilization of PrEP/PEP of the MSM. MSM collected dry blood spot (DBS) samples by themselves, and mailed the DBS samples to laboratory for HIV nucleic acid testing. Open cohort was established and those with HIV negative nucleic acid testing results were followed up. Non-conditional binary logistic regression method was used to identify the associated factors for high risk anal sex in the last month and having multiple homosexual partners in the last month. A total of 1 147 MSM were recruited, and follow up for 236 person years was conducted in 956 MSM with negative HIV nucleic acid testing results. The detection rate of new HIV infection was 1.3 per 100 person-years (3/236). During the last month, the proportions of consistent condom use in anal sex and oral sex were 50.7% (238/469) and 4.9% (23/469). In the MSM, 5.9% (43/723) had sex with HIV positive partners in the last month. 9.8% (103/1 049) used PrEP, and 8.7% (91/1 049) used PEP. The proportion of consistent condom use in PrEP and PEP were 34.3% (24/70) and 72.2% (39/54) respectively. Logistic regression analysis revealed that compared with those who used no PrEP/PEP, those who used PrEP/PEP were more likely to have unprotected anal sex in the last month (a=3.16, 95%:1.45-7.18), and more likely to have multiple homosexual partners in the last month (a=2.64, 95%:1.19-6.30), and compared with those who used no Rush Popper or drugs in the last month, those who used Rush Popper or drugs in the last month were more likely to have unprotected anal sex in the last month (a=2.34, 95%:1.67-3.30), and more likely to have multiple homosexual partners (a=2.42,95%:1.76-3.33). It is necessary to strengthen the health education to promote condom use and introduce the harm of drug use in MSM. In PrEP and PEP services, it is still necessary to suggest consistent condom use for MSM.
为了解北京市男男性行为者（MSM）中艾滋病病毒（HIV）感染率、高危行为及暴露前预防/暴露后预防（PrEP/PEP）使用情况。采用Epi Info 7.0软件估计调查和队列研究的样本量分别为1227人和207人年。采用方便抽样法，通过微信应用招募MSM。在线完成问卷以收集MSM的人口学特征、高危行为及PrEP/PEP使用情况等信息。MSM自行采集干血斑（DBS）样本，并将DBS样本邮寄至实验室进行HIV核酸检测。建立开放队列，对HIV核酸检测结果为阴性者进行随访。采用非条件二元逻辑回归方法确定过去1个月内高危肛交及过去1个月内有多个男性性伴的相关因素。共招募1147名MSM，对956名HIV核酸检测结果为阴性的MSM进行了236人年的随访。HIV新感染率为每100人年1.3例（3/236）。在过去1个月内，肛交和口交时全程使用避孕套的比例分别为50.7%（238/469）和4.9%（23/469）。在MSM中，5.9%（43/723）在过去1个月内与HIV阳性性伴发生过性行为。9.8%（103/1049）使用过PrEP，8.7%（91/1049）使用过PEP。PrEP和PEP中全程使用避孕套的比例分别为34.3%（24/70）和72.2%（39/54）。逻辑回归分析显示，与未使用PrEP/PEP者相比，使用PrEP/PEP者在过去1个月内发生无保护肛交的可能性更大（α=3.16，95%可信区间：1.45 - 7.18），在过去1个月内有多个男性性伴的可能性更大（α=2.64，95%可信区间：1.19 - 6.30）；与过去1个月内未使用过催情药或毒品者相比，过去1个月内使用过催情药或毒品者在过去1个月内发生无保护肛交的可能性更大（α=2.34，95%可信区间：1.67 - 3.30），有多个男性性伴的可能性更大（α=2.42，95%可信区间：1.76 - 3.33）。有必要加强健康教育以促进MSM使用避孕套并介绍吸毒的危害。在PrEP和PEP服务中，仍有必要建议MSM全程使用避孕套。
