Su Rong, Liu Yi, Li Peilong, Ge Lin, Liao Meizhen, Fu Yong, Song Xin, Tang Houlin, Li Dongmin
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Shandong Center for Disease Control and Prevention, Ji'nan, China.
BMC Infect Dis. 2025 Mar 27;25(1):421. doi: 10.1186/s12879-025-10795-9.
Men who have sex with men (MSM) are key populations for HIV infection. Post-exposure prophylaxis (PEP) has been confirmed to be an effective measure for preventing HIV transmission. This study aimed to investigate the usage of PEP among MSM in Qingdao and its associated factors, analyze the impact of PEP usage on risk behaviors, and offer insights for HIV prevention.
Between April and August 2021, a cross-sectional survey was conducted in Qingdao, relying on local community-based organizations (CBOs) and employing a snowball sampling method to recruit eligible MSM. We gathered sociodemographic information, behavioral data, and PEP usage details from the participants. The analysis of factors associated with PEP utilization among MSM was performed using a logistic regression model. Subsequently, a follow-up visit was conducted six months later, collecting behavioral information from the participants. Generalized estimating equations fitting Poisson regression were utilized to analyze behavioral changes during the follow-up for PEP users and non-PEP users.
A total of 602 MSM were enrolled in this study, with a median age of 30.0 years. Among them, 140 individuals used PEP in the last 6 months, resulting in a usage rate of 23.3% (140/602). Factors associated with PEP usage included monthly income ≥ 5000 RMB (aOR = 2.092, 95%CI: 1.366-3.203) and engaging in group sex ≥ 3 times in the last 6 months (aOR = 1.844, 95%CI: 1.067-3.189). In the follow-up survey, 467 individuals participated, comprising 112 PEP users and 355 non-PEP users. Compared to the baseline, the proportion of non-PEP users with Rush Popper usage frequency ≥ 1 time/week increased from 19.3% to 34.4% during follow-up (RR = 1.671, 95%CI: 1.302-2.146), and the proportion of those engaging in unprotected anal intercourse in the past 6 months increased from 95.5% to 98.6% (RR = 1.029, 95%CI: 1.004-1.056). However, the risk behaviors of PEP users exhibited no significant changes during the study period (P > 0.05).
Higher frequency of group sex and higher monthly income emerged as facilitating factors for PEP usage among MSM in Qingdao. Beyond its efficacy in preventing HIV infection, PEP may also play a role in managing the occurrence of risk behaviors among MSM. Consequently, there is a pressing need to intensify efforts to promote PEP uptake among MSM as a strategy to control the spread of HIV.
男男性行为者（MSM）是艾滋病病毒（HIV）感染的重点人群。暴露后预防（PEP）已被确认为预防HIV传播的有效措施。本研究旨在调查青岛市男男性行为者中PEP的使用情况及其相关因素，分析PEP使用对危险行为的影响，并为HIV预防提供见解。
2021年4月至8月，在青岛市进行了一项横断面调查，依托当地社区组织（CBO），采用滚雪球抽样方法招募符合条件的男男性行为者。我们收集了参与者的社会人口学信息、行为数据和PEP使用细节。采用逻辑回归模型分析男男性行为者中与PEP使用相关的因素。随后，在6个月后进行随访，收集参与者的行为信息。使用广义估计方程拟合泊松回归分析PEP使用者和非PEP使用者随访期间的行为变化。
本研究共纳入602名男男性行为者，中位年龄为30.0岁。其中，140人在过去6个月内使用过PEP，使用率为23.3%（140/602）。与PEP使用相关的因素包括月收入≥5000元（调整后比值比[aOR]=2.092，95%置信区间[CI]：1.366-3.203）以及在过去6个月内有≥3次群交行为（aOR=1.844，95%CI：1.067-3.189）。在随访调查中，467人参与，其中包括112名PEP使用者和355名非PEP使用者。与基线相比，非PEP使用者中Rush Popper使用频率≥每周1次的比例在随访期间从19.3%增加到34.4%（相对危险度[RR]=1.671，95%CI：1.302-2.146），过去6个月内进行无保护肛交的比例从95.5%增加到98.6%（RR=1.029，95%CI：1.004-1.056）。然而，PEP使用者的危险行为在研究期间无显著变化（P>0.05）。
较高的群交频率和较高的月收入是青岛市男男性行为者使用PEP的促进因素。除了预防HIV感染的效果外，PEP还可能在管理男男性行为者危险行为的发生方面发挥作用。因此，迫切需要加大力度促进男男性行为者使用PEP，作为控制HIV传播的策略。
