de Sousa Álvaro Francisco Lopes, Nunes Ribeiro Caíque Jordan, Santos Guilherme Reis de Santana, de Oliveira Layze Braz, Camargo Emerson Lucas Silva, Lima Shirley Verônica Melo Almeida, de Oliveira Sena Inara Viviane, Bezerra-Santos Márcio, Batista Odinéa Maria Amorim, Reis de Sousa Anderson, Mendes Isabel Amélia Costa
Hospital Sírio-Libânes, Instituto de Ensino e Pesquisa, São Paulo, Daher Cutait, 69 - Bela Vista, São Paulo - SP, 01308-060, Brazil.
Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
Ther Adv Infect Dis. 2023 Oct 27;10:20499361231206918. doi: 10.1177/20499361231206918. eCollection 2023 Jan-Dec.
Pre-exposure prophylaxis (PrEP) is a valuable tool in the response to the HIV epidemic, recommended for groups with a higher risk of HIV infection, such as men who have sex with men (MSM), particularly in the context of high-risk sexual behavior such as chemsex.
This study aimed to analyze the prevalence and factors associated with the intention to use PrEP among MSM who engage in chemsex in Brazil and Portugal.
This was a cross-sectional study of a secondary dataset from a larger study conducted between January 2020 and May 2021 throughout Brazil and Portugal involving 1852 MSM who engage in chemsex. An initial descriptive analysis was performed to calculate the absolute and relative frequencies of independent variables related to the intention to use PrEP among MSM. A multivariate regression model was developed to identify factors independently associated with the intention to use PrEP.
Although a high level of PrEP knowledge (85.75%) was observed among MSM who engage in chemsex, the prevalence of intention to use PrEP was only 59.07%. Five variables were associated with a higher prevalence of intention to use PrEP [engaging in double penetration - adjusted prevalence ratio (aPR): 1.56, 95% CI: 1.44-1.69; being assigned female sex at birth - aPR: 1.34, 95% CI: 1.12-1.61; cruising - aPR: 1.21, 95% CI: 1.06-1.38; not using condoms - aPR: 1.20, 95% CI: 1.05-1.36; and being an immigrant - aPR: 1.16; 95% CI: 1.07-1.25], while having knowledge of postexposure prophylaxis (aPR: 0.91; 95% CI: 0.84-0.98), having a casual sexual partner (aPR: 0.86 and 0.85; 95% CI: 0.74-0.99 and 0.74-0.98), and engaging in group sex (aPR: 0.81; 95% CI: 0.73-0.90) were associated with a lower intention to use PrEP.
The intention to use PrEP among MSM who engage in chemsex was high, and several factors were associated with this intention. Understanding the factors associated with the intention to use PrEP among MSM practicing chemsex is crucial for developing targeted interventions to increase PrEP uptake in this population. The results of this study suggest that tailored approaches are necessary to promote PrEP use in this population.
暴露前预防（PrEP）是应对艾滋病毒流行的一项重要工具，推荐给艾滋病毒感染风险较高的群体，如同性恋男性（MSM），尤其是在诸如使用毒品后性行为等高危性行为的背景下。
本研究旨在分析巴西和葡萄牙参与使用毒品后性行为的男男性行为者中PrEP使用意愿的患病率及相关因素。
这是一项对2020年1月至2021年5月在巴西和葡萄牙开展的一项更大规模研究的二次数据集进行的横断面研究，涉及1852名参与使用毒品后性行为的男男性行为者。进行了初步描述性分析，以计算与男男性行为者中PrEP使用意愿相关的独立变量的绝对和相对频率。建立了多元回归模型以确定与PrEP使用意愿独立相关的因素。
尽管在参与使用毒品后性行为的男男性行为者中观察到较高水平的PrEP知识（85.75%），但PrEP使用意愿的患病率仅为59.07%。五个变量与较高的PrEP使用意愿患病率相关[进行双重插入——调整患病率比（aPR）：1.56，95%置信区间：1.44 - 1.69；出生时被指定为女性——aPR：1.34，95%置信区间：1.12 - 1.61；寻找性伙伴——aPR：1.21，95%置信区间：1.06 - 1.38；不使用避孕套——aPR：1.20，95%置信区间：1.05 - 1.36；以及为移民——aPR：1.16；95%置信区间：1.07 - 1.25]，而了解暴露后预防（aPR：0.91；95%置信区间：0.84 - 0.98）、有临时性伴侣（aPR：0.86和0.85；95%置信区间：0.74 - 0.99和0.74 - 0.98）以及参与群交（aPR：0.81；95%置信区间：0.73 - 0.90）与较低的PrEP使用意愿相关。
参与使用毒品后性行为的男男性行为者中PrEP使用意愿较高，且有几个因素与该意愿相关。了解参与使用毒品后性行为的男男性行为者中与PrEP使用意愿相关的因素对于制定针对性干预措施以提高该人群中PrEP的接受率至关重要。本研究结果表明，需要采取量身定制的方法来促进该人群中PrEP的使用。
