Tu Zhengcheng, He Shiyi, Zhao Rui, Tieosapjaroen Warittha, Zhang Ying, Zhao Min, Ong Jason J, Zhang Lei
Olin Business School, Washington University in St. Louis, St. Louis, MO, USA.
China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, PR China.
AIDS Behav. 2025 Jun 4. doi: 10.1007/s10461-025-04793-w.
Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV in gay, bisexual, and other men who have sex with men (GBMSM). This study investigates PrEP usage and preferences among Chinese GBMSM and how key attributes influence their choices using a discrete choice experiment (DCE). Six PrEP attributes were evaluated: dosing frequency, dispensing venue, side effects, effectiveness, follow-up frequency, and extra services. From January to November 2022, a face-to-face survey was conducted among 1186 GBMSM in Xi'an, China. Multi- and mixed-logit models assessed preferences and heterogeneity by demographics. Latent class analysis examined unobserved preference patterns, and scenario analysis explored how changes in attributes affect PrEP acceptance. Among 995 valid participants (mean age 34 ± 9 years), 20.5% had ever used PrEP. The most influential attribute was dosing frequency, followed by side effects and follow-up frequency. Participants preferred on-demand PrEP, private dispensing venues, minimal side effects, at least 60% effectiveness, follow-up every 3 months, and comprehensive STI testing. Preferences varied by age, education, and income. Latent class analysis indicated 57.04% of participants preferred on-demand PrEP, STD/social health clinics, very low-risk kidney complications, 80% effectiveness, 3-month follow-up, and no extra services. Scenario analysis showed on-demand PrEP and 80% effectiveness would increase acceptance by 73.6% and 43.2%, respectively, compared to daily oral PrEP and 30% effectiveness. Conversely, switching from daily oral pills to bi-monthly injections decreased acceptance by 48.2%. Dosing frequency is the most influential attribute for HIV PrEP among Chinese GBMSM. Preferences vary by demographics, and reduced dosing and improved effectiveness may substantially boost uptake.
暴露前预防（PrEP）在预防男同性恋、双性恋和其他与男性发生性行为的男性（GBMSM）感染艾滋病毒方面非常有效。本研究使用离散选择实验（DCE）调查了中国GBMSM中PrEP的使用情况和偏好，以及关键属性如何影响他们的选择。评估了六个PrEP属性：给药频率、配药地点、副作用、有效性、随访频率和额外服务。2022年1月至11月，在中国西安对1186名GBMSM进行了面对面调查。多分类和混合逻辑模型按人口统计学评估偏好和异质性。潜在类别分析检查未观察到的偏好模式，情景分析探讨属性变化如何影响PrEP的接受度。在995名有效参与者（平均年龄34±9岁）中，20.5%曾使用过PrEP。最有影响力的属性是给药频率，其次是副作用和随访频率。参与者更喜欢按需PrEP、私人配药地点、最小副作用、至少60%的有效性、每3个月随访一次以及全面的性传播感染检测。偏好因年龄、教育程度和收入而异。潜在类别分析表明，57.04%的参与者更喜欢按需PrEP、性病/社会健康诊所、极低风险的肾脏并发症、80%的有效性、3个月随访且无额外服务。情景分析表明，与每日口服PrEP和30%的有效性相比，按需PrEP和80%的有效性将分别使接受度提高73.6%和43.2%。相反，从每日口服药丸改为每两个月注射一次会使接受度降低48.2%。给药频率是中国GBMSM中艾滋病毒PrEP最有影响力的属性。偏好因人口统计学而异，减少给药次数和提高有效性可能会大幅提高使用率。
