Bui Hao T M, Adamson Paul C, Klausner Jeffrey D, Le Giang M, Gorbach Pamina M
Center for Training and Research on Substance Abuse - HIV, Hanoi Medical University, Hanoi, Viet Nam
Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, USA.
Sex Transm Infect. 2025 Feb 6. doi: 10.1136/sextrans-2024-056449.
Doxycycline prophylaxis shows promise for bacterial sexually transmitted infection (STI) prevention, but data primarily come from high-income countries. This study assessed awareness, willingness and factors associated with willingness to use doxycycline for bacterial STI prevention among men who have sex with men (MSM) using HIV pre-exposure prophylaxis (HIV-PrEP) in Vietnam.
Between 25 January and 4 February 2024, a cross-sectional study recruited males aged ≥18 years who reported having sex with men in the past 12 months from 11 HIV-PrEP clinics in Hanoi and Ho Chi Minh City. Self-administered surveys were conducted, and multivariable logistic regression was applied to identify factors associated with willingness to use doxycycline prophylaxis.
Among 350 participants, the median age was 25 (IQR 21-30), and 10.6% self-reported a bacterial STI diagnosis in the past 12 months. In the previous 6 months, the median number of sex partners was 2 (IQR 1-4), 53.1% reported condomless anal sex. Awareness of doxycycline was low (20.2%; 65/322); however, 75.4% (264/350) expressed willingness to use it, with 63.6% (168/264) preferring doxyPrEP. Participants who disclosed HIV-PrEP use to all sex partners (adjusted OR (aOR) 4.17; 95% CI 1.84, 9.46) and those with higher perceived STI risk (aOR 1.12; 95% CI 1.03, 1.22) were more likely to report willingness to use doxycycline prophylaxis. Concerns about daily medication (aOR 0.43; 95% CI 0.24, 0.81) and fear of judgement from peers (aOR 0.41; 95% CI 0.21, 0.81) were associated with lower willingness.
Knowledge of doxycycline prophylaxis among MSM on HIV-PrEP in Vietnam was low. However, most expressed willingness to use it, with two-thirds preferring doxyPrEP. Findings highlight the need to disseminate information on doxycycline prophylaxis for bacterial STI prevention, monitoring the usage and evaluating comparative effectiveness of doxyPEP and doxyPrEP to guide implementation efforts in Vietnam.
多西环素预防用药在细菌性性传播感染（STI）预防方面显示出前景，但数据主要来自高收入国家。本研究评估了越南使用艾滋病毒暴露前预防（HIV-PrEP）的男男性行为者（MSM）对使用多西环素预防细菌性STI的知晓情况、意愿及相关因素。
2024年1月25日至2月4日，一项横断面研究从河内和胡志明市的11家HIV-PrEP诊所招募了年龄≥18岁且报告在过去12个月内与男性发生过性行为的男性。进行了自填式调查，并应用多变量逻辑回归来确定与使用多西环素预防用药意愿相关的因素。
在350名参与者中，年龄中位数为25岁（四分位间距21 - 30岁），10.6%的人自我报告在过去12个月内被诊断患有细菌性STI。在之前的6个月中，性伴侣数量中位数为2个（四分位间距1 - 4个），53.1%的人报告有无保护肛交。对多西环素的知晓率较低（20.2%；65/322）；然而，75.4%（264/350）的人表示愿意使用，其中63.6%（168/264）的人更喜欢多西环素与HIV-PrEP联合用药（doxyPrEP）。向所有性伴侣披露使用HIV-PrEP的参与者（调整后比值比（aOR）4.17；95%置信区间1.84，9.46）以及那些认为自己感染STI风险较高的参与者（aOR 1.12；95%置信区间1.03，1.22）更有可能报告愿意使用多西环素预防用药。对每日用药的担忧（aOR 0.43；95%置信区间0.24，0.81）和对来自同伴评判恐惧（aOR 0.41；95%置信区间0.21，0.81）与较低的意愿相关。
越南使用HIV-PrEP的MSM对多西环素预防用药的知晓率较低。然而，大多数人表示愿意使用，其中三分之二的人更喜欢doxyPrEP。研究结果强调需要传播关于多西环素预防细菌性STI的信息，监测其使用情况并评估多西环素预防用药（doxyPEP）和多西环素与HIV-PrEP联合用药（doxyPrEP）的相对有效性，以指导越南的实施工作。
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