Fang Quan, Tang Gan, Wang Ziwei, Guo Qian, Guo Qisheng, Fan Yinguang, Qin Qirong
Lishui Center for Disease Control and Prevention, Lishui, Zhejiang Province, PR China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
PLoS One. 2025 May 22;20(5):e0324259. doi: 10.1371/journal.pone.0324259. eCollection 2025.
Men who have sex with men (MSM) are disproportionately affected by HIV and represent the primary target population for pre-exposure prophylaxis (PrEP) use. However, PrEP adoption in China remains limited, partly due to its late regulatory approval. This study aims to investigate the awareness and willingness of PrEP use and associated factors among MSM in Maanshan city, so as to promote the popularization of PrEP.
This cross-sectional study was conducted in Maanshan City, China, between June 2016 and December 2019. Participants completed the questionnaire through respondent-driven sampling (RDS). The questionnaire information was organized and analyzed using SPSS 23.0 software. Both univariate and multivariate logistic regression models were employed to investigate the determinants of PrEP willingness and awareness among HIV-negative MSM.
A total of 879 participants were enrolled, with 837 providing analyzable data. The majority (62.25%) were aged <30 years old, with 97.49% self-identified as homosexual. Among participants, 50.18% reported regular male sexual partners. Regarding sexual behaviors, 71.80% of MSM engaged in casual sex and 36.56% unprotected anal sex (UAI) within the last six months. HIV awareness was reported by 92.83% of respondents, while PrEP awareness was substantially lower (22.70%). Willingness to use PrEP was high (89.49%), with 16.49% preferring to take PrEP daily and 84.59% preferring to take PrEP on demand. Multivariate logistic regression revealed that vocational school (vs. high school or below), recent casual sex engagement, PrEP awareness, and recent UAI history were significant predictors of PrEP willingness. Higher education (university or above vs. high school or below), versatile sexual role (vs. op/insertive ones), recent casual sex and prior HIV testing were positively associated with PrEP awareness.
Maanshan's MSM population demonstrated high PrEP acceptance but limited awareness. The findings suggest that expanding access to HIV testing could enhance PrEP awareness. Simultaneously, PrEP dissemination combined with targeted HIV prevention may effectively reduce HIV transmission in the MSM population.
男男性行为者（MSM）受艾滋病毒影响的比例过高，是暴露前预防（PrEP）用药的主要目标人群。然而，PrEP在中国的采用率仍然有限，部分原因是其监管批准较晚。本研究旨在调查马鞍山市男男性行为者对PrEP的知晓率和使用意愿及其相关因素，以促进PrEP的推广。
本横断面研究于2016年6月至2019年12月在中国马鞍山市进行。参与者通过应答驱动抽样（RDS）完成问卷。问卷信息使用SPSS 23.0软件进行整理和分析。单因素和多因素逻辑回归模型均用于调查HIV阴性男男性行为者中PrEP意愿和知晓率的决定因素。
共纳入879名参与者，其中837名提供了可分析的数据。大多数（62.25%）年龄<30岁，97.49%自我认定为同性恋。参与者中，50.18%报告有固定男性性伴侣。在性行为方面，71.80%的男男性行为者在过去六个月内有过随意性行为，36.56%有过无保护肛交（UAI）。92.83%的受访者报告知晓艾滋病毒，而PrEP知晓率则低得多（22.70%）。使用PrEP的意愿较高（89.49%），16.49%的人倾向于每日服用PrEP，84.59%的人倾向于按需服用PrEP。多因素逻辑回归显示，职业学校（相对于高中或以下学历）、近期有随意性行为、知晓PrEP以及近期有无保护肛交史是PrEP意愿的重要预测因素。高等教育（大学及以上相对于高中或以下学历）、性角色多样（相对于被动/插入方）、近期有随意性行为以及既往艾滋病毒检测与PrEP知晓率呈正相关。
马鞍山市的男男性行为人群对PrEP接受度较高，但知晓率有限。研究结果表明，扩大艾滋病毒检测的可及性可以提高PrEP知晓率。同时，PrEP的推广与针对性的艾滋病毒预防相结合，可能有效减少男男性行为人群中的艾滋病毒传播。
