多性伴并存MSM性关系特征及暴露前预防使用状况分析  

Relationship characteristics and pre-exposure prophylaxis use among men who have sex with men with multiple concurrent sexual partners

作　　者：崔文博 黄鹏翔 胡苏兰 王霖 李亚君 王国永 郝连正 马伟 CUI Wenbo;HUANG Pengxiang;HU Sulan;WANG Lin;LI Yajun;WANG Guoyong;HAO Lianzheng;MA Wei(School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 25001l,Shandong,China;Rushan Center for Disease Control and Prevention,Weihai 264500,Shandong,China;Shandong Center for Disease Control and Prevention,Jinan 25001l,Shandong,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院,济南250011 [2]乳山市疾病预防控制中心,山东威海264500 [3]山东省疾病控制预防中心,济南250011

出　　处：《中国艾滋病性病》2025年第3期288-293,共6页Chinese Journal of Aids & STD

基　　金：山东省自然科学基金项目(ZR2022MH160);山东省医药卫生科技发展计划项目(202112050690)。

摘　　要：目的 调查山东省多性伴并存MSM的性关系特征、PrEP的使用情况,分析PrEP使用的影响因素,以提高PrEP的使用率,降低HIV传播风险。方法 研究采用受试者驱动抽样方法,在2024年5至7月期间,招募352名多性伴并存MSM,收集参与者的基本信息、性关系特征、暴露前预防使用情况。采用R软件,通过单因素方差分析和多变量贝叶斯回归模型探讨PrEP使用的影响因素。结果 352名多性伴并存MSM中,PrEP的使用率为28.69%。PrEP使用的促进因素包括自评HIV高风险(aOR=3.55,95%CI:1.74~6.60),知晓PrEP知识(aOR=8.74,95%CI:4.09~16.85),存在HIV阳性或者HIV状态未知的性伴侣(aOR=2.94,95%CI:1.30~5.79),存在无保护肛交行为(aOR=3.28,95%CI:1.35~6.69),存在吸毒性伴侣(aOR=2.01,95%CI:0.95~3.82),同伴教育(aOR=10.58,95%CI:1.31~48.18);PrEP使用的阻碍因素包括居住在农村(aOR=0.27,95%CI:0.07~0.70),本科以下(aOR=0.49,95%CI:0.21~0.96),月收入≤3000元(aOR=0.41,95%CI:0.10~1.10),高PrEP污名评分(aOR=0.95,95%CI:0.92~0.98)。结论 山东省多性伴并存MSM目前PrEP使用率仍较低,针对农村、收入和学历较低、拥有吸毒性伴侣、存在高危性行为的多性伴并存MSM,仍应加强宣传教育,提高此类人群PrEP知识知晓率,增强PrEP的可及性,从而提高PrEP覆盖率。Objective To investigate the relationship between characteristics and pre-exposure prophylaxis(PrEP)use among men who have sex with men(MSM) with multiple concurrent sexual partners in Shandong Province and to analyze the factors influencing pre-exposure prophylaxis(PrEP) use to increase PrEP uptake and reduce the risk of HIV transmission. Methods The respondent-driven sampling method was used to recruit 352 MSM with multiple concurrent sexual partners from May to July 2024 and basic information, relationship characteristics, and PrEP use was collected.One-way analysis of variance(ANOVA) and multivariate Bayesian regression models were employed in R software to explore factors influencing PrEP use. Results Among the 352 MSM engaging in sexual concurrency, 28.69% used PrEP.Factors promoting PrEP use included self-assessment of high HIV risk(aOR=3.55, 95%CI:1.74-6.60), knowledge of PrEP(a OR=8.74, 95%CI:4.09-16.85), having partners who are HIV-positive or of unknown HIV status(aOR=2.94, 95%CI:1.30-5.79), engaging in unprotected anal intercourse(aOR=3.28, 95%CI:1.35-6.69), having partners who use drugs(aOR=2.01,95%CI: 0.95-3.82), and participation in peer education(aOR=10.58, 95%CI: 1.31-48.18). Barriers to PrEP use included residing in rural areas(a OR=0.27, 95%CI: 0.07-0.70), having an education level below a bachelor's degree(a OR=0.49, 95%CI: 0.21-0.96), earning a monthly income of ≤3 000 RMB(a OR=0.41, 95%CI: 0.10-1.10), and having a high Pr EP stigma score(a OR=0.95, 95%CI: 0.92-0.98). Conclusions Current Pr EP uptake among MSM engaged in sexual concurrency in Shandong Province remains low. Strengthened education and outreach efforts are needed, particularly for those in rural areas with lower income and education levels and those who engage in high-risk sexual behaviors or with drug-using partners, to improve Pr EP awareness and accessibility, thereby increasing Pr EP coverage.

关 键 词：艾滋病病毒 男男性行为者 性关系特征 多性伴并存 暴露前预防 

分 类 号：R183[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]