Du Jun, Wang Sainan, Zhang Hongbo, Liu Tao, Sun Shufang, Yang Cui, Zaller Nickolas, Dai Zhen, Zha Haipeng, Zhao Yanqiu, Zhao Yue, Hu Xuejiao, Yan Han, Gao Pan, Wang Jun, Sun Yehuan, Zhang Zhihua, Don Operario
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
AIDS Behav. 2025 May;29(5):1629-1639. doi: 10.1007/s10461-025-04633-x. Epub 2025 Jan 30.
This study aimed to explore the awareness, willingness, and engagement with pre-exposure prophylaxis (PrEP) among high-risk Chinese men who have sex with men (MSM) and to investigate the factors influencing its use. A cross-sectional survey of 1800 HIV-negative MSM was conducted in Chengdu, Suzhou, and Wuhan between June 2022 and February 2023 through in-person and online recruitment methods. Univariate and multivariate logistic regression analyses were used to identify predictors of PrEP use. Bayesian network models were constructed using the bnlearn package in R 4.1.2, and inference was conducted using Netica software. Among the 1800 participants, 1467 had ever heard of PrEP, 696 were aware of its target population, and 195 had taken PrEP in the past 6 months. PrEP use was higher among individuals reporting multiple male sex partners, illicit substance use, alcohol use, HIV testing, PEP use, and sexual partners who had used PrEP. Conversely, having a female sexual partner was a barrier to PrEP use. Bayesian network modeling unveiled factors directly and indirectly impacting PrEP use. Variables like PrEP use of sexual partners, PEP use, alcohol use, HIV testing, and WeChat-based HIV knowledge platforms exhibited direct effects. Indirect effects included having a female sexual partner, number of male sexual partners, and illicit substance use. Despite high awareness, the usage of PrEP remains low among MSM. Encouraging social agencies to leverage social media platforms to provide comprehensive HIV care services, especially to meet the PrEP needs of MSM.
本研究旨在探讨中国高危男男性行为者（MSM）对暴露前预防（PrEP）的知晓情况、意愿及参与度，并调查影响其使用的因素。2022年6月至2023年2月期间，通过现场和在线招募的方式，在成都、苏州和武汉对1800名HIV阴性的MSM进行了横断面调查。采用单因素和多因素逻辑回归分析来确定PrEP使用的预测因素。使用R 4.1.2中的bnlearn包构建贝叶斯网络模型，并使用Netica软件进行推理。在1800名参与者中，1467人曾听说过PrEP，696人知晓其目标人群，195人在过去6个月内服用过PrEP。报告有多个男性性伴侣、使用非法物质、饮酒、进行过HIV检测、使用过暴露后预防（PEP）以及性伴侣使用过PrEP的个体中，PrEP的使用率较高。相反，有女性性伴侣是PrEP使用的一个障碍。贝叶斯网络建模揭示了直接和间接影响PrEP使用的因素。性伴侣的PrEP使用、PEP使用、饮酒、HIV检测以及基于微信的HIV知识平台等变量表现出直接影响。间接影响包括有女性性伴侣、男性性伴侣数量以及使用非法物质。尽管知晓率较高，但MSM中PrEP的使用率仍然较低。鼓励社会机构利用社交媒体平台提供全面的HIV护理服务，特别是满足MSM的PrEP需求。
