参加暴露前预防的男男性行为者HIV自我检测试剂使用现状及影响因素分析

目的分析参加暴露前预防(PrEP)MSM的HIV自我检测(自检)试剂使用现状及相关影响因素。方法2018年12月至2019年12月,使用"金数据"平台(www.jinshuju.com)对沈阳市、北京市、重庆市和深圳市参与多中心PrEP研究的MSM进行现况调查。结果共有1222例MSM研究对象,年龄(31.5±8.7)岁,最近3个月性伴数为3(P25,P75:2,6)个,与固定性伴、偶然性伴和商业性伴发生肛交时未使用安全套的比例分别为62.7%(456/727)、56.3%(440/781)和41.0%(16/39)。曾使用过HIV自检试剂的比例为74.5%(910/1222),最近1年HIV自检次数为3(P25,P75:2,5)次。多因素logistic回归分析结果显示,HIV自检行为的相关影响因素中,分别相比于>40岁组、初中及以下文化程度、心理认同性别为女性、PrEP服药方式为事件驱动服药组、最近3个月未使用过新型毒品,18~岁组(aOR=2.06,95%CI:1.35~3.14)、26~岁组(aOR=2.72,95%CI:1.77~4.17)和31~岁组(aOR=1.76,95%CI:1.19~2.59)、文化程度大学本科/大专(aOR=2.18,95%CI:1.35~3.49)和研究生及以上(aOR=3.06,95%CI:1.69~5.54)、心理认同性别为男性(aOR=3.22,95%CI:1.55~6.70)、PrEP服药方式为每日服药组(aOR=1.35,95%CI:1.03~1.78)、最近3个月使用过新型毒品(aOR=1.72,95%CI:1.30~2.28)的HIV自检行为的比例更高。结论MSM参与PrEP者HIV自检行为的比例较高,但高年龄组、PrEP服药方式为事件驱动服药及未使用过新型毒品的MSM对HIV自检行为比例较低。为评估PrEP使用效果及依从性,需为HIV自检比例较低的MSM提供更完善的自检服务。

HIV self-testing reagent use in pre-exposure prophylaxis and related factors in men who have sex with men

Objective To understand the current status of HIV self-testing reagent use in pre-exposure prophylaxis (PrEP) and related factors in men who have sex with men (MSM).Methods From December 2018 to December 2019, "Gold data" online platform (www.jinshuju.com) was used to conduct multicenter PrEP studies in Shenyang, Beijing, Chongqing and Shenzhen of China.Results A total of 1 222 MSM PrEP users were included in the multicenter study. The average age of the participants was (31.5±8.7) years, and the number of sexual partners in the past three months was 3 (P₂₅,P₇₅:2,6). The proportions of those who did not use condoms in anal sex with fixed, casual and commercial partners were 62.7% (456/727), 56.3% (440/781) and 41.0% (16/39), respectively. Up to 74.5% (910/1 222) of participants had used HIV self-testing reagents, and the number of HIV self-testing during last year was 3 (P₂₅,P₇₅:2,5). The multivariate logistic regression analysis indicated that compared with age group >40 years, those with education level of junior high school or below, those with psychological identity as female, event driven PrEP users, those never using new type drugs in past 3 months, the participants aged 18years (aOR=2.06, 95%CI:1.35-3.14), 26years (aOR=2.72, 95%CI:1.77-4.17), 31years (aOR=1.76, 95%CI:1.19-2.59), undergraduates (aOR=2.18, 95%CI:1.35-3.49), graduate students and above (aOR=3.06, 95%CI:1.69-5.54), those with psychological identity as male (aOR=3.22, 95%CI:1.55-6.70), daily PrEP users (aOR=1.35, 95%CI:1.03-1.78), and new type drug users in the past three months (aOR=1.72, 95%CI:1.30-2.28) had higher proportions of HIV self-testing behaviors.Conclusions The proportion of HIV self-testing in MSM PrEP users was high, while it was relatively low in older age group, event driven PrEP users and MSM never using new type drugs. To assess and improve the effectiveness and compliance of PrEPs, it is necessary to provide better HIV self-testing service for MSM with low HIV self-testing rate.