Su R, Zhu L M, Huang G H, Li P L, Ge L, Liao M Z, Fu Y, Song X, Li D M
Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Department of AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Ji'nan 250014, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Jan 10;45(1):134-138. doi: 10.3760/cma.j.cn112338-20230530-00339.
To understand the use of post-exposure prophylaxis (PEP) and analyze related factors among men who have sex with men (MSM) in Qingdao, and provide a reference for the AIDS prevention and control in this population. A cross-sectional survey conducted from April 2022 to February 2023. Relying on MSM social groups in Qingdao, a snowball sampling method was applied to recruit research subjects who met the inclusion criteria of age ≥18 years old, having had homosexual anal or oral sex in the past six months, and HIV-negative or infection status unknown. The sample size was estimated at 566. Data on demographic characteristics, sexual behavior characteristics, PEP use, and others of the research subjects was collected through on-site questionnaires. The logistic regression model was used to analyze the factors associated with using PEP. A total of 811 participants were recruited, mainly aged 25-34 (53.6%, 435/811), unmarried (74.7%, 606/811), with an average monthly income of ≥5 000 yuan (52.2%, 423/811), and having lived in Qingdao for ≥10 years (75.6%, 613/811). The proportion of those who knew the HIV status of their sexual partners in the last six months was 67.1% (544/811), and those with HIV-positive partners were 3.6% (29/811). In the last six months, the proportion of participants who had group sex (86.4%, 701/811), unprotected anal sex (98.2%, 796/811), and use of club drugs (80.3%, 651/811) was high. Moreover, 28.4% (230/811) had used PEP. The multivariate logistic regression analysis showed that the factors related to the use of PEP included divorced or widowed (a=5.46,95%:1.96-15.17), average monthly income ≥5 000 yuan (a=2.04,95%:1.44-2.89), same-sex sexual orientation (a=0.40,95%:0.22-0.71), having HIV-positive sexual partners in the last six months (a=2.54,95%:1.13-5.71) and having been tested for HIV ≥3 times in the last six months (a=1.46,95%:1.04-2.06). The prevalence of risk behaviors among MSM in Qingdao was high, and the use of PEP was low. In the future, it is essential to increase HIV/AIDS prevention education among MSM, promote MSM to know the HIV status of their sexual partners, and reduce the prevalence of risk behaviors among this population. Additionally, explore medical insurance reimbursement plans for PEP to reduce utilization costs and promote the use of PEP by MSM after HIV exposure occurs as soon as possible.
了解青岛市男男性行为者（MSM）暴露后预防（PEP）的使用情况并分析相关因素，为该人群的艾滋病防控提供参考。于2022年4月至2023年2月进行了一项横断面调查。依托青岛市的MSM社会群体，采用雪球抽样方法招募年龄≥18岁、在过去六个月内有过同性肛交或口交、HIV阴性或感染状况未知且符合纳入标准的研究对象。样本量估计为566。通过现场问卷调查收集研究对象的人口学特征、性行为特征、PEP使用情况等数据。采用logistic回归模型分析与使用PEP相关的因素。共招募了811名参与者，主要年龄在25 - 34岁（53.6%，435/811），未婚（74.7%，606/811），月平均收入≥5000元（52.2%，423/811），在青岛居住≥10年（75.6%，613/811）。在过去六个月中，知道其性伴侣HIV状况的比例为67.1%（544/811），有HIV阳性伴侣的为3.6%（29/811）。在过去六个月中，有群交行为（86.4%，701/811）、无保护肛交（98.2%，796/811）和使用俱乐部药物（80.3%，651/811）的参与者比例较高。此外，28.4%（230/811）使用过PEP。多因素logistic回归分析显示，与使用PEP相关的因素包括离婚或丧偶（a = 5.46，95%：1.96 - 15.17）、月平均收入≥5000元（a = 2.04，95%：1.44 - 2.89）、同性性取向（a = 0.40，95%：0.22 - 0.71）、在过去六个月中有HIV阳性性伴侣（a = 2.54，95%：1.13 - 5.71）以及在过去六个月中接受HIV检测≥3次（a = 1.46，95%：1.04 - 2.06）。青岛市MSM中危险行为的流行率较高，而PEP的使用率较低。未来，有必要加强对MSM的艾滋病预防教育，促使MSM了解其性伴侣的HIV状况，降低该人群中危险行为的流行率。此外，探索PEP的医疗保险报销方案，降低使用成本，促进MSM在HIV暴露后尽快使用PEP。
