Beijing Huilongguan Hospital, Beijing, China.
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
HIV Med. 2024 Sep;25(9):1075-1085. doi: 10.1111/hiv.13663. Epub 2024 May 21.
The objective of this study was to gain insight into the barriers hindering the use of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in five cities in China.
MSM were recruited via community-based organizations in an online "snowball" manner. Participants completed the questionnaire anonymously and shared it with key MSM peers (seeds) in five cities in China. Based on the results of univariate analysis, we used a structural equation model to analyse the role of PrEP knowledge awareness, PrEP counselling, and other behavioural variables on PrEP use.
The study collected a total of 4223 valid questionnaires, and 18.2% of participants reported PrEP use. The results of the standardized total effects showed that the following paths were statistically significant (p < 0.05): from the age of first sex with men to PrEP knowledge awareness (β = -0.113) and PrEP use (β = 0.042); from high-risk sexual behaviour scores to PrEP counselling (β = 0.039) and PrEP use (β = 0.103); from the number of HIV tests in the last year to PrEP knowledge awareness (β = 0.034), PrEP counselling (β = 0.170), and PrEP use (β = 0.197); from the level of self-perceived risk of HIV infection to PrEP counselling (β = -0.115); from PrEP knowledge awareness to PrEP use (β = -0.049); and from PrEP counselling to PrEP use (β = 0.420).
The proportion of PrEP use among MSM was relatively low. Age at first sex with men, number of HIV tests, high-risk sexual behaviour, and PrEP counselling had a positive effect on PrEP use, whereas PrEP knowledge awareness had an inverse effect on PrEP use.
本研究旨在深入了解中国五个城市男男性行为者（MSM）使用暴露前预防（PrEP）的障碍。
通过社区组织以在线“滚雪球”的方式招募 MSM。参与者匿名完成问卷，并与中国五个城市的关键 MSM 同伴（种子）分享。基于单变量分析的结果，我们使用结构方程模型分析 PrEP 知识意识、PrEP 咨询以及其他行为变量对 PrEP 使用的作用。
研究共收集了 4223 份有效问卷，18.2%的参与者报告使用了 PrEP。标准化总效应的结果表明，以下路径具有统计学意义（p<0.05）：从首次与男性发生性关系的年龄到 PrEP 知识意识（β=-0.113）和 PrEP 使用（β=0.042）；从高危性行为评分到 PrEP 咨询（β=0.039）和 PrEP 使用（β=0.103）；从去年进行的 HIV 检测次数到 PrEP 知识意识（β=0.034）、PrEP 咨询（β=0.170）和 PrEP 使用（β=0.197）；从自我感知的 HIV 感染风险程度到 PrEP 咨询（β=-0.115）；从 PrEP 知识意识到 PrEP 使用（β=-0.049）；以及从 PrEP 咨询到 PrEP 使用（β=0.420）。
MSM 中 PrEP 的使用比例相对较低。首次与男性发生性关系的年龄、HIV 检测次数、高危性行为以及 PrEP 咨询对 PrEP 使用有积极影响，而 PrEP 知识意识对 PrEP 使用有负面影响。
