男男性行为者HIV暴露前预防药物使用者服药依从性研究  

The compliance of HIV pre-exposure prophylaxis uptake among MSM

作　　者：朱玉荣 田梅丽 殷文渊[1] 赵德才[1] 刘潇 薛盼盼 徐杰[1] ZHU Yurong;TIAN Meili;YIN Wenyuan;ZHAO Decai;LIU Xiao;XUE Panpan;XU Jie(National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中国艾滋病性病》2023年第5期549-553,共5页Chinese Journal of Aids & STD

基　　金：中美艾滋病防治合作项目(GAP)后续研究计划(2011-2022)。

摘　　要：目的 了解我国MSM暴露前预防(PrEP)药物使用者服药依从性,及其相关影响因素。方法 2022年9月22日至11月12日,在北京等八个城市的MSM中运用滚雪球的方式招募服用过HIV暴露前预防药物者,利用自行设计的电子问卷收集调查对象社会人口学、性行为、对PrEP的认知、PrEP药物的获取和使用等信息。运用Logistics回归模型分析PrEP服药依从性的影响因素。结果 共调查479名使用过PrEP药物的MSM,平均年龄为(29.9±7.2)岁,未婚占86.6%(415人),大专/本科及以上占84.1%(403人),88.7%(425人)自我认同为同性恋。近6个月当中14.8%(71人)只用过每日服药方案,69.5%(333人)只用过按需服药方案,15.7%(75人)两种方案都使用过,距调查时最近的方案为每日服药方案的和按需服药方案分别占19.0%(91人)和81.0%,(388人)。调查对象当中PrEP服药依从的人数占81.4%(390人)。“自我感知高HIV感染风险”(OR=4.21,95%CI:1.53~11.93)、“服药前仔细了解过PrEP相关注意事项”(OR=3.73,95%CI:1.03~14.51)、“认为PrEP对个人健康保护的评分为比较重要和非常重要”(OR依次为3.74和4.92,95%CI依次为1.37~10.20和1.94~12.46)以及“经常使用安全套”(OR=2.69,95%CI:1.35~5.39)等因素和服药依从密切相关。结论 调查MSM暴露前预防用药的服药依从性较好,但仍存在着服药不规范的行为,需要加强依从性教育,尤其是对于高危性行为多发的重点人群,提高服药人群对PrEP的信心,促进MSM规范服药。Objective To explore the compliance of pre-exposure prophylaxis(PrEP)uptake and associated factors among MSM(men who have sex with men).Methods From September 22 to November 12,2022,snowball sampling was used to recruit MSM who had taken HIV PrEP in eight cities.A self-designed app-based electronic questionnaire was used to collect socio-demographic information,sexual behavior characteristics,PrEP awareness,and the access and use of PrEP.Logistic regression model was used to explore the factors influencing PrEP uptake compliance.Results A total of 479 PrEP respondents among MSM were enrolled,with the average age was(29.9±7.2)years old,of whom,86.6%(415)were unmarried,84.1%(403)were college/bachelor or higher degree,and 88.7%(425)were self-identified as homosexual.In the past 6 months,14.8%(71)of the respondents had only used daily regimen,69.5%(333)had only used demand-driven regimen,and 15.7%(75)had used the both regimens.The latest plan of this questionnaire survey was daily regimen,with a percentage of 19.0%(91 people),while was the demand-driven regimen with 81.0%(388 people),respectively.Totally 81.4%(390)of the respondents were compliant in PrEP uptake.Logistic regression analysis demonstrated that,"self-perceived high risk of HIV infection"(OR=4.21,95%CI:1.53-11.93),"had learnt carefully about PrEP before taking the pills"(OR=3.73,95%CI:1.03-14.51),"rated PrEP as relatively and very significant for personal healthcare"(OR=3.73 and OR=4.92;95%CI:1.37-10.20 and 95%CI:1.94-12.46),and"to use condom frequently"(OR=2.69,95%CI:1.35-5.39)were related to PrEP compliance.Conclusions The proportion of PrEP compliance among the investigated MSM are relatively high.However,there are still substandard behaviors in medication use.It is necessary to strengthencomplianceeducation,especially for population with high risk sexual behavior,to improve the confidence of population using PrEP,and to promote medication standardized among MSM.

关 键 词：暴露前预防 依从性 男男性行为者 

分 类 号：R512.91[医药卫生—内科学]