Knowledge awareness and its influencing factors of HIV pre-exposure prophylaxis among MSM
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摘要:
目的 了解不同城市和年份的男男性行为者(men who have sex with men, MSM)对HIV暴露前预防(pre-exposure prophylaxis, PrEP)知识知晓变化情况及其影响因素。 方法 依托社区组织分别在2019年和2021年采用电子问卷收集北京市、深圳市和昆明市的MSM人群的基本社会人口学情况、PrEP知识知晓、行为学情况等，并进行相关因素分析。 结果 共调查4 889名MSM，其中2019年2 399人，2021年2 490人。2019年PrEP知识知晓占6.29%，2021年占25.02%。多因素logistic回归分析模型分析结果显示，2019年调查对象PrEP知识知晓促进因素包括年龄在25~ < 35岁(OR=1.685, 95% CI: 1.007~2.821)和≥35岁(OR=29.01, 95% CI: 1.156~3.497)、咨询过PrEP(OR=1.731, 95% CI: 1.050~2.855)、暴露后预防(post-exposure prophylaxis, PEP)知识知晓(OR=3.178, 95% CI: 2.079~4.860)。2021年调查对象PrEP知识知晓相关因素包括文化程度(本科/大专：OR=3.291, 95% CI: 1.595~6.793；研究生及以上：OR=4.507, 95% CI: 2.104~9.652)、曾咨询过PrEP(OR=2.591, 95% CI: 1.906~3.521)、PEP知识知晓(OR=5.855, 95% CI: 3.071~11.161)、使用过PEP(OR=1.619, 95% CI: 1.191~2.200)、使用助性剂(OR=0.623, 95% CI: 0.492~0.789)、一年内检测次数为3~4次(OR=2.140, 95% CI: 1.265~3.619)和≥5次(OR=3.414, 95% CI: 1.987~5.865)。 结论 2021年MSM的PrEP知识知晓水平较2019年大幅度提高，但总体仍然低。影响知晓水平的相关因素包括MSM年龄、文化程度、进行过HIV检测、知晓及应用过PEP措施等，应继续采取综合性的措施加强对MSM人群关于PrEP的宣传教育，提高其对PrEP正确的认知。 Abstract:Objective To understand the knowledge awareness and its influencing factors of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in different cities and years. Methods In 2019 and 2021, an electronic questionnaire was used to collect information including sociodemographic characteristics, PrEP knowledge awareness, and behavior characteristics of MSM in Beijing, Shenzhen, and Kunming. Questionnaires were collected by community organizations. Then the influencing factors of PrEP knowledge awareness were analyzed. Results A total of 4 889 questionnaires were collected in the three cities, including 2 399 in 2019 and 2 490 in 2021. The knowledge awareness rates of PrEP in 2019 and 2021 were 6.29% and 25.02% respectively. In 2019, multivariate logistic regression analysis model showed that ages (25- < 34 years old: OR=1.685, 95% CI: 1.007-2.821; ≥ 35 years old: OR=2.01, 95% CI: 1.156-3.497), consulted PrEP (OR=1.731, 95% CI: 1.050-2.855), heard of PEP (Post-exposure prophylaxis) (OR=3.178, 95% CI: 2.079-4.860) were related to the PrEP knowledge awareness. In 2021, multivariate logistic regression analysis showed that education (universities or colleges: OR=3.291, 95% CI: 1.595-6.793; master degree or above: OR=4.507, 95% CI: 2.104-9.652), consulted PrEP (OR=2.591, 95% CI: 1.906-3.521), heard of PEP (OR=5.855, 95% CI: 3.071-11.161), used PEP (OR=1.619, 95% CI: 1.191-2.200), used stimulant (OR=0.623, 95% CI: 0.492-0.789), tested HIV in a year (3-4 times: OR=2.140, 95% CI: 1.265-3.619; ≥5: OR=3.414, 95% CI: 1.987-5.865) were related to the PrEP knowledge awareness. Conclusions PrEP knowledge awareness in 2021 has increased significantly compared with 2019 among MSM, but remained low overall. The age, education, HIV testing times, knowledge awareness and uptake of PEP were related to the PrEP knowledge awareness. Comprehensive measures should be continued to strengthen the publicity and education of PrEP to MSM and improve their correct understanding of PrEP. -
Key words:
- AIDS /
- Men who have sex with men /
- Pre-exposure prophylaxis
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表 1 2019和2021年调查对象PrEP知识知晓情况的比较[n(%)]
Table 1. Comparison of knowledge about PrEP among respondents in 2019 and 2021 [n(%)]
基本情况 2019年 2021年 总例数(N=2 399) 知晓(n=151) 不知晓(n=2 248) χ2值 P值 总例数(N=2 490) 知晓(n=623) 不知晓(n=1 867) χ2值 P值 年龄(岁) 7.840 0.020 8.367 0.015 18~＜25 510(21.2) 19(3.7) 491(96.3) 263(10.6) 59(22.4) 204(77.6) 25~＜35 1 271(53.0) 85(6.7) 1 186(93.3) 1 230(49.4) 339(27.6) 891(72.4) ≥35 618(25.8) 47(7.6) 571(92.4) 997(40.0) 225(36.1) 772(41.4) 文化程度 3.346 0.339 52.711 ＜0.001 初中及以下 168(7.0) 11(6.5) 157(93.5) 194(7.8) 23(11.) 171(88.1) 高中(中专) 376(15.7) 24(6.4) 352(93.6) 407(16.3) 72(17.7) 335(82.3) 本科/大专 1 566(65.3) 91(5.8) 1 475(94.2) 1 554(62.4) 407(26.2) 1 147(73.8) 研究生及以上 289(12.0) 25(8.7) 264(91.3) 335(13.5) 121(36.1) 214(63.9) 工作情况 3.540 0.060 5.707 0.017 有工作 1 888(78.7) 128(6.8) 1 760(93.2) 1 979(79.5) 516(26.1) 1 463(73.9) 无工作 511(21.3) 23(4.5) 488(95.5) 511(20.5) 107(20.9) 404(79.1) 月收入(元) 4.911 0.086 19.908 ＜0.001 0 248(10.3) 9(3.6) 239(96.4) 161(6.5) 45(28.0) 116(72.0) ＜5 000 816(34.0) 47(5.8) 769(94.2) 731(29.3) 139(19.0) 592(81.0) ≥5 000 1 335(55.7) 95(7.1) 1 240(92.9) 1 598(64.2) 439(27.5) 1 159(72.5) 咨询过PrEP 22.249 ＜0.001 90.911 ＜0.001 是 652(10.1) 66(43.7) 586(89.9) 1 121(45.0) 383(34.2) 738(65.8) 否 1 747(72.8) 85(4.9) 1 662(95.1) 1 369(55.0) 240(17.5) 1 129(82.5) PEP知识知晓a 49.575 ＜0.001 109.892 ＜0.001 知晓 931(1.7) 103(11.1) 828(88.9) 1 480(65.8) 494(33.4) 986(66.6) 不知晓 1 304(58.3) 46(3.5) 1 258(96.5) 770(34.2) 99(12.9) 671(87.1) 咨询过PEP a 15.820 ＜0.001 29.255 ＜0.001 是 748(33.5) 72(9.6) 676(90.4) 1 106(49.2) 348(31.5) 758(68.5) 否 1 487(66.5) 77(5.2) 1 410(94.8) 1 144(50.8) 245(21.4) 899(78.6) 使用过PEP a 3.373 0.066 19.989 ＜0.001 是 334(15.0) 30(9.0) 304(91.0) 567(25.2) 190(33.5) 377(66.5) 否 1 900(85.0) 119(6.3) 1 781(93.7) 1 683(74.8) 403(23.9) 1 280(76.1) 发生同性性行为使用安全套的情况b 0.746 0.689 0.148 0.929 从不使用 115(6.6) 5(4.3) 110(95.7) 101(5.8) 28(27.7) 73(72.3) 有时使用 447(25.6) 29(6.5) 418(93.5) 602(34.4) 174(28.9) 428(71.1) 每次使用 1 186(67.8) 74(6.2) 1 112(93.8) 1 047(59.8) 294(28.1) 753(71.9) 群交情况b 2.863 0.091 0.457 0.499 是 279(16.0) 11(3.9) 268(96.1) 1 477(84.4) 414(28.0) 1 063(72.0) 否 1 469(84.0) 97(6.6) 1 372(93.4) 273(15.6) 82(30.0) 191(70.0) 检测出性病情况 1.215 0.270 0.347 0.556 是 343(14.3) 17(5.0) 326(95.0) 131(7.4) 34(26.0) 97(74.0) 否 2 056(85.7) 134(6.5) 1 922(93.5) 1 636(92.6) 464(28.4) 1 172(71.6) 助性剂使用情况b 2.601 0.107 5.020 0.025 是 778(44.5) 40(5.1) 738(94.9) 886(50.6) 230(26.0) 656(74.0) 否 970(55.5) 68(7.0) 902(92.9) 864(49.4) 266(30.8) 598(69.2) 1年HIV检测次数(次) 4.812 0.186 105.390 ＜0.001 0 418(17.5) 26(6.2) 392(93.8) 283(11.4) 38(13.4) 245(86.6) 1~2 1 212(50.6) 66(5.4) 1 146(94.5) 1 055(42.4) 207(19.6) 848(80.4) 3~4 601(25.1) 44(7.3) 557(92.7) 719(28.9) 196(27.3) 523(72.7) ≥5 164(6.8) 15(9.1) 149(90.9) 433(17.4) 182(42.0) 251(58.0) 注：a听说过PEP的调查对象才继续进行PEP知识知晓、咨询和使用情况的调查，因此人数少于每年总例数；b 2019年调查的是近3个月有无以上行为，2021年是近6个月有无以上行为。 
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表 2 2019和2021年调查对象PrEP知识知晓情况的多因素Logistic回归分析[n(%)]
Table 2. Multivariate logistic regression analysis of influencing factors of respondents' knowledge awareness of PrEP in 2019 and 2021 [n(%)]
基本情况 2019年 2021年 总例数 OR(95% CI)值 总例数 OR(95% CI)值 年龄(岁) 18~＜25 510(21.2) 1.000 263(10.6) 1.000 25~＜35 1 271(53.0) 1.685(1.007~2.821) 1 230(49.4) 1.213(0.785~1.873) ≥35 618(25.8) 2.010(1.156~3.497) 997(40.0) 1.147(0.729~1.805) 文化程度 初中及以下 168(7.0) 194(7.8) 1.000 高中(中专) 376(15.7) 407(16.3) 2.102(0.973~4.538) 本科/大专 1 566(65.3) 1 554(62.4) 3.291(1.595~6.793) 研究生及以上 289(12.0) 335(13.5) 4.507(2.104~9.652) 工作情况 无工作 1 888(78.7) 1 979(79.5) 1.000 有工作 511(21.3) 511(20.5) 1.462(0.994~2.149) 月收入(元) 0 248(10.3) 161(6.5) 1.000 ＜5 000 816(34.0) 731(29.3) 0.741(0.412~1.330) ≥5 000 1 335(55.7) 1 598(64.2) 0.747(0.412~1.353) 咨询过PrEP 否 652(27.2) 1.000 1 121(45.0) 1.000 是 1 747(72.8) 1.731(1.050~2.855) 1 369(55.0) 2.591(1.906~3.521) PEP知识知晓 不知晓 931(41.7) 1.000 1 480(65.8) 1.000 知晓 1 304(58.3) 3.178(2.079~4.860) 770(34.2) 5.855(3.071~11.161) 咨询过PEP 否 748(33.5) 1.000 1 106(49.2) 1.000 是 1 487(66.5) 1.483(0.904~2.433) 1 144(50.8) 0.731(0.521~1.027) 使用过PEP 否 334(15.0) 567(25.2) 1.000 是 1 900(85.0) 1 683(74.8) 1.619(1.191~2.200) 助性剂使用情况 否 778(44.5) 886(50.6) 1.000 是 970(55.5) 864(49.4) 0.623(0.492~0.789) 一年内HIV检测次数(次) 0 418(17.5) 283(11.4) 1.000 1~2 1 212(50.6) 1 055(42.4) 1.554(0.925~2.610) 3~4 601(25.1) 719(28.9) 2.140(1.265~3.619) ≥5 164(6.8) 433(17.4) 3.414(1.987~5.865)
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