成都市男男性行为者的暴露前预防用药动机级联现状及其影响因素  

Motivational PrEP cascade and influencing factors among men who have sex with men in Chengdu

作　　者：杨潇 陈晓婷 曹望楠[2] 郭雅伟 顾菁[1] 李菁华 郝元涛 YANG Xiao;CHEN Xiaoting;CAO Wangnan;CUO Yawei;GU Jing;LI Jinghua;HAO Yuantao(School of Public Health,Sun Yatsen University,Guangzhou 510080,China;School of Public Health,Peking University,Beijing 100191;Global Health Institute,Sun Yat-sen University,Guangzhou 510080)

机构地区：[1]中山大学公共卫生学院,广州510080 [2]北京大学公共卫生学院,北京100191 [3]中山大学全球卫生研究中心,广州510080

出　　处：《中国艾滋病性病》2023年第4期408-412,共5页Chinese Journal of Aids & STD

基　　金：国家自然科学基金(81803334);国家科技重大专项(2018ZX10715004)。

摘　　要：目的 了解成都市MSM暴露前预防用药(PrEP)动机级联各阶段现状及其差距的影响因素。方法 采用方便抽样法在四川省成都市招募对PrEP有客观需求的成年MSM。使用网络问卷收集人口学特征、HIV感染相关行为特征和PrEP动机级联现状等资料。使用Logistic回归探索进入PrEP意向阶段和准备阶段的影响因素。结果 共纳入318名对PrEP有客观需求的MSM,平均年龄为(28.7±9.0)岁。其中,124人(39.0%)进入PrEP意向阶段,53人(16.7%)进入PrEP准备阶段,25人(7.9%)进入PrEP使用阶段,12人(3.8%)进入PrEP维持和依从阶段。多因素分析结果显示,最近6个月没有发生过商业性性行为、害怕感染HIV、周围有人使用PrEP和认为性伴会支持自己使用PrEP的MSM更有可能进入PrEP意向阶段。最近6个月做过HIV检测、认为自己在未来1年感染HIV的可能性大、周围有人使用PrEP、认为朋友会支持自己使用PrEP的MSM更有可能进入PrEP准备阶段。结论 大部分对PrEP有客观需求的MSM没有进入PrEP意向或准备阶段。未来PrEP推广工作应重点帮助MSM正确认识自身HIV感染风险,同时加强PrEP宣传,提高MSM及其社交网络成员对PrEP的接受程度。Objective To investigate the motivational PrEP cascade and the influencing factors of its gap among men who have sex with men(MSM) in Chengdu, China. Methods Self-reported PrEP-eligible adult MSM were recruited by convenient sampling in Chengdu, Sichuan Province. Sociodemographic characteristics, HIV-related characteristics, and the motivational PrEP cascade were surveyed through web-based questionnaires. Logistic regression model was used to explore the influencing factors of entering the PrEP contemplation and preparation stage. Results A total of 318 PrEPeligible MSM were included, with an average age of 28.7±9.0 years old. Among them, 124(39.0%) entered the PrEP contemplation stage, 53(16.7%) entered the PrEParation stage, 25(7.9%) entered the PrEP action and initiation stage, and 12 finally entered the PrEP maintenance and adherence stage. Multivariate analysis showed that participants who had not participated in commercial sex in the last 6 months, felt afraid of acquiring HIV, had someone using PrEP around them,and perceived that their sexual partners would support their PrEP use were more likely to enter the PrEP contemplation stage. It was also found that participants who had an HIV test in the last 6 months, perceived a high risk of HIV infection in the next year, had someone using PrEP around them, and perceived that their friends would support their PrEP use, were more likely to enter the PrEParation stage. Conclusions The majority of PrEP-eligible MSM did not enter the PrEP contemplation or preparation stage. More attention should be paid to improving MSM's correct awareness and knowledge of PrEP and strengthening the positive publicity of PrEP in the future PrEP promotion, to improve the acceptance of PrEP by MSM and its friends.

关 键 词：男男性行为者 暴露前预防用药 级联 

分 类 号：R512.91[医药卫生—内科学]