我国四川、广西、新疆地区女性性工作者对暴露前预防用药预防HIV感染接受意愿调查

目的 了解我国四川省、新疆维吾尔自治区、广西壮族自治区女性性工作者( FSWs)对暴露前预防用药(Pr-EP)预防人类免疫缺陷病毒(HIV)感染的接受意愿及其影响因素.方法 采用问卷调查的形式,调查对象为四川省、新疆维吾尔自治区、广西壮族自治区的FSWs.调查完成问卷1 478份,有效问卷1 469份(占99.39％).调查内容主要为FSWs对Pr-EP的知晓情况和接受意愿.结果 经调查人员介绍了Pr-EP相关知识后,在Pr-EP安全有效的前提下,共有801人(54.5％)表示“肯定愿意使用”,有196人(13.3％)表示“可能会使用”,Pr-EP使用意愿为67.9％ (997/1469),三个地区间的差异无统计学意义(p＞0.05).经过单因素x2检验和Logistic回归分析,结果显示:Pr-EP的接受意愿的影响因素包括危险自评(OR=1.776,P=0.005)、性服务安全套使用(OR=1.346,P=0.000)、最近三次发生性交易使用安全套的频率(OR=1.519,P=0.003)、是否使用过药物预防性病(OR=1.185,P =0.025)、是否拒绝与不使用安全套的人发生性行为(OR=1.479,P=0.009)、是否会建议朋友接受Pr-EP(OR =5.618,P=0.000).三个地区FSWs对Pr-EP比较关注的是其安全性/不良反应、效果/有效性、费用.结论 坚持使用安全套的FSWs更倾向于接受Pr-EP；应该加大Pr-EP相关知识的宣传力度,提高FSWs对Pr-EP知晓率,进一步提高FSWs对于Pr-EP的接受意愿；同伴教育可能是推广Pr-EP的有效方式.

Investigation on acceptability of pre-exposure prophylaxis among female sex workers in Sichuan, Xinjiang and Guangxi of China

Objective To investigate the acceptability and influencing factors of pre-exposure prophylaxis(Pr-EP) for human immunodeficiency virus(HIV) among female sex workers(FSWs) in Sichuan,Xinjiang and Guangxi of China.Methods FSWs selected from Sichuan,Xinjiang and Guangxi were surveyed with questionnaires.A total of 1 478 questionnaires were completed,among which 1 469(99.39%) were effective.The survey mainly concerned with the awareness and acceptability of FSWs on Pr-EP.Results After introduction to Pr-EP by the investigators,under the precondition that Pr-EP was effective and safe,997(67.9%) FSWs accepted Pr-EP,and there was no significant difference in the acceptability among FSWs in three regions(P>0.05).Univariate χ2 analysis and Logistic regression analysis revealed that self-evaluation of risks(OR=1.776,P=0.005),regular condom use in sex service(OR=1.346,P=0.000),frequency of condom use during the latest three times of sex service(OR=1.519,P=0.003),drug use to prevent sexually-transmitted disease(OR=1.185,P=0.025),refusal of having sex with those without condom use(OR=1.479,P=0.009) and advising peers to use Pr-EP(OR=5.618,P=0.000) were influencing factors of acceptability of Pr-EP.FSWs mainly concerned of the security,effectiveness and cost of Pr-EP.Conclusion FSWs with regular condom use are more likely to accept Pr-EP.Pr-EP related knowledge should be well exposed among FSWs to increase the awareness and acceptability.Peer education may be a better way to improve the acceptability of Pr-EP.