摘要目的 对上海市男男性行为者(men who have sex with men, MSM)HIV暴露前预防(pre-exposure prophylaxis, PrEP)认知、接受意愿及影响因素进行评估。 方法 采用横断面研究设计,使用滚雪球抽样通过上海某自愿咨询检测门诊及网络社群招募研究对象进行问卷调查。 结果 共获得有效问卷606份,87.8%的调查对象听说过PrEP,46.9%“绝对愿意”使用PrEP服务,86.4%能够接受的个人承担费用在500元/月以下。多因素logistic回归分析显示,外地户籍(OR=1.477,95%CI:1.028~2.123)、近1年有过无套口交或肛交(OR=1.827,95%CI:1.181~2.827)、认为PrEP让自己在性生活中掌握更多主动权(OR=2.480,95%CI:1.727~3.563)、近1年无固定伴侣者(OR=1.649,95%CI:1.111~2.448)有更强烈的PrEP使用意愿,而异性恋(OR=0.261,95%CI:0.099~0.684)、担心使用PrEP会暴露隐私并影响个人形象(OR=0.656,95%CI:0.446~0.964)的调查对象具有较弱的使用意愿。 结论 上海市MSM具有较高的PrEP知晓率和一定PrEP接受意愿,外地户籍、有无套性行为、无固定性伴、异性恋MSM应作为PrEP服务的重点对象,创造无歧视环境有利于PrEP服务开展。
Abstract:Objective To evaluate the awareness, willingness to use and influencing factors of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Shanghai. Methods This study was designed as a cross-sectional survey. MSM were recruited and investigated through a NGO-based HIV voluntary counseling and testing clinic and several virtual communities using snowball sampling. Results A total of 606 valid questionnaires were collected. 87.8% of the surveyed subjects had heard of PrEP, 46.9% of them held absolute willingness to use PrEP, and 86.4% of them expected the monthly individual cost of using PrEP to be less than 500 yuan. Multivariable logistic regression analysis revealed that MSM as migrants (OR=1.477,95%CI:1.028-2.123), having oral or anal sex without condoms in the last year (OR=1.827, 95%CI:1.181-2.827), without regular sexual partners in the last year (OR=1.649, 95%CI:1.111-2.448), and believing using PrEP could make themselves more self-determined in sex (OR=2.480,95%CI:1.727-3.563) had higher willingness to use PrEP, whereas MSM who were heterosexual (OR=0.261, 95%CI:0.099-0.684) and who were worrying about privacy disclosure (OR=0.656,95%CI:0.446-0.964) were less likely to use PrEP. Conclusion MSM in Shanghai have a relatively high awareness of PrEP and a moderate willingness to use it. MSM who are non-local residents, with condomless intercourse, without regular sexual partners and who are heterosexual need to be focused on in promoting PrEP use. Reducing stigma and discrimination is conducive to PrEP implementation.
郑亦慧, 谢言, 魏巍. 上海市男男性行为者HIV暴露前预防认知、接受意愿及其影响因素分析[J]. 实用预防医学, 2021, 28(7): 802-806.
ZHENG Yi-hui, XIE Yan, WEI Wei. Awareness, willingness to use and influencing factors of HIV pre-exposureprophylaxis amongst men who have sex with men in Shanghai. , 2021, 28(7): 802-806.
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