摘要
目的了解昆明市男男性行为者(MSM)对HIV暴露前预防用药(PrEP)的认知、使用意愿及影响因素,为开展PrEP提供依据。方法采取定量和定性相结合的方法调查年龄≥16岁、最近1年有过男男肛交性行为、HIV阴性的MSM。定量调查采用非概率"滚雪球"抽样法,内容含人口学特征、个人性行为、PrEP知晓及使用意愿等;定性调查采用立意抽样,了解其对PrEP的看法认知、药物不免费时PrEP的使用意愿、心理期望及HIV预防措施等。结果有效调查MSM396人,63.9%(253/396)听说过PrEP,如果药物免费,92.4%(366/396)的人有PrEP使用意愿。多因素非条件Logistic回归分析显示:认为自己未来5年内可能会感染HIV(OR=14.192)、不担心PrEP价格(OR=6.023)、听说过PrEP(OR=3.291)、非婚姻关系同居(OR=6.603)是MSM对PrEP使用意愿的独立促进因素。圈内人对PrEP的反对态度(OR=0.015)是MSM对PrEP使用意愿的独立阻碍因素。定性访谈结果显示:11人中,8人听说过PrEP,但其中5人不了解具体是什么;当药物不是免费时,因价格高有不良反应且有效性不是100%,8人表示暂时不会使用;如果未来要使用,愿意支付945.5~1 000元/月。结论昆明市MSM对PrEP的使用意愿较高,但认知不足,个人风险意识、圈内人的态度、听说过PrEP及价格可能是PrEP使用意愿的影响因素。
Objective To understand the cognition,intention to use and influencing factors of HIV pre-exposure prophylaxis(PrEP)among men who have sex with men(MSM)in Kunming Province,in order to provide evidence for PrEP program. Methods Quantitative and qualitative methods were carried out to investigate MSM patients aged ≥16 years,who had anal sex with men in the last year and HIV negative. Non-probabilistic"snowball"sampling was used in the quantitative survey,which included demographic characteristics,personal sexual behavior,PrEP awareness and usage intention,etc. Qualitative adopted the method of intention sampling,including cognition of PrEP,willingness to use when not free,psychological expectations,and prevention measures of HIV,etc. Results A total of 396 valid questionnaires were collected. 63.9%(253/396)had heard of PrEP,if the drug was free,92.4%(366/396)were willing to take PrEP. Multivariate Logistic regression analysis showed that likely to be infected with HIV over the next five years(OR=14.192),no worry about PrEP expensive cannot afford(OR=6.023),had heard of PrEP(OR=3.291),and non-marital cohabitation(OR=6.603)were independent protect factors to use PrEP. The against for PrEP by gay friend(OR=0.015)was independent obstructive factors. The qualitative showed that 8 out of 11 MSM had heard of PrEP,but 5 person did not know what is PrEP. When it was not free 8 out of 11 said would not use drug because of the high prices,side effects and efficacy was not100%. They were willing to pay 945.5~1 000.0 yuan a month if needed in the future. Conclusion The willingness of HIV PrEP use among MSM in Kunming is high,but lack of cognition. Personal risk awareness,attitude of gay friend,have heard of PrEP and the price may be the influening factors of PrEP to use.
作者
王玉淼
肖璨
马婧
潘松峰
陆林
马艳玲
王珏
李佑芳
WANG Yu-miao;XIAO Can;MA Jing;PAN Song-feng;LU Lin;MA Yan-ling;WANG Jue;LI You-fang(Yunnan Provincial Center for Disease Control and Prevention,Kunming 650022,China;Kunming Medical University;Health Commission of Yunnan Province)
出处
《华南预防医学》
2021年第3期279-283,共5页
South China Journal of Preventive Medicine
基金
十三五科技重大专项(2017ZX10201101002011)。
