Increases in human papillomavirus vaccine coverage over 12 months among a community-recruited cohort of gay,bisexual, and other men who have sex with men in Canada

BackgroundStarting in 2015/16, most Canadian provinces introduced publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) aged ≤ 26 years. We estimated 12-month changes in HPV vaccine coverage among community-recruited GBM from 2017 to 2021 and identified baseline factors associated with vaccine initiation (≥1 dose) or series completion (3 doses) among participants who were unvaccinated or partially vaccinated at baseline.MethodsWe recruited sexually-active GBM aged ≥ 16 years in Montreal, Toronto, and Vancouver, Canada, from 02/2017 to 08/2019 and followed them over a median of 12 months (interquartile range = 12–13 months). We calculated the proportion who initiated vaccination (≥1 dose) or completed the series (3 doses) by 12-month follow-up. Analyses were stratified by city and age-eligibility for the publicly-funded programs at baseline (≤26 years or > 26 years). We used multivariable logistic regression to identify baseline factors associated with self-reported incident vaccine initiation or series completion.ResultsAmong 165 unvaccinated participants aged ≤ 26 years at baseline, incident vaccine initiation (≥1 dose) during follow-up was 24.1% in Montreal, 33.3% in Toronto, and 38.9% in Vancouver. Among 1,059 unvaccinated participants aged > 26 years, incident vaccine initiation was 3.4%, 8.9%, and 10.9%, respectively. Higher education and trying to access pre-exposure prophylaxis for HIV were associated with incident vaccination among those aged ≤ 26 years, while younger age, residing in Vancouver (vs. Montreal), being diagnosed with anogenital warts, having both government and private extended medical insurance, and being vaccinated against influenza were associated with incident vaccination among those aged > 26 years.ConclusionsWe observed substantial gains in HPV vaccine coverage among young GBM within 5 + years of targeted program implementation, but gaps remain, particularly among older men who are ineligible for publicly-funded programs. Findings suggest the need for expanded public funding or insurance coverage for HPV vaccines.     

Human papillomavirus (HPV) vaccine uptake among a community-recruited sample of gay,bisexual, and other men who have sex with men in the three largest cities in Canada from 2017 to 2019

IntroductionIn 2015/2016, Canada’s largest provinces implemented publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) ≤ 26 years old. We sought to describe HPV vaccine uptake among GBM and determine barriers and facilitators to vaccine initiation with a focus on healthcare access and utilization.MethodsEngage is a cohort study among GBM aged 16 + years in three Canadian cities recruited from 2017 to 2019 via respondent driven sampling (RDS). Men completed a comprehensive questionnaire at baseline. By publicly-funded vaccine eligibility (≤26 years old = eligible for vaccination, ≥27 years old = ineligible), we described HPV vaccine uptake (initiation = 1 + dose, completion = 3 doses) and explored factors associated with vaccine initiation using Poisson regression. All analyses were weighted with the RDS-II Volz-Heckathorn estimator.ResultsAcross the three cities, 26–35% and 14–21% of men ≤ 26 years and 7–26% and 2–9% of men ≥ 27 years initiated and completed HPV vaccination, respectively. Vaccine initiation was significantly associated with STI/HIV testing or visiting a HIV care specialist in the past six months (≤26: prevalence ratio[PR] = 2.15, 95% confidence interval[CI] 1.06–4.36; ≥27: PR = 2.73, 95%CI 1.14–6.51) and past hepatitis A or B vaccination (≤26: PR = 2.88, 95%CI 1.64–5.05; ≥27: PR = 2.03, 95%CI 1.07–3.86). Among men ≥ 27 years old, vaccine initiation was also positively associated with accessing PrEP, living in Vancouver or Toronto, but negatively associated with identifying as Latin American and increasing age. Vaccine initiation was twice as likely among men ≥ 27 years with private insurance versus no insurance.ConclusionsSixty-five to 74% of men eligible for publicly-funded vaccine across the three cities remained unvaccinated against HPV by 2019. High vaccine cost may partly explain even lower uptake among men ≥ 27 years old. Men seeking sexual health care were more likely to initiate vaccination; bundling vaccination with these services may help improve HPV vaccine uptake.     

Morbidity and mortality related to human immunodeficiency virus in Canadian men and women, 1987-94.

OBJECTIVE: To assess the impact of HIV/AIDS on hospitalization and mortality patterns in Canada. METHODS: Hospitalizations and deaths due to HIV/AIDS were compared with select causes of morbidity and mortality among men and women across provinces, regions and select cities between 1987-94. Patterns of hospitalization and mortality were characterized by calculating age-specific, standardized rates, rate ratios and potential years of life lost before 65 years. RESULTS: A total of 28,462 hospitalizations (26,153 in men and 2,309 in women) and 8,739 deaths (8,192 in men and 547 in women) were attributed to HIV/AIDS during the study period. Rates of HIV/AIDS hospitalization were highest for men in Ontario, Quebec and British Columbia, and in Montreal, Toronto and Vancouver; while among women they were highest in Quebec and in Montreal, Toronto and Vancouver. Mortality rates followed a pattern similar to the rates found for hospitalization. CONCLUSIONS: Our analysis reveals the considerable impact of HIV/AIDS on patterns of morbidity and mortality in Canada.     

我国24个城市男男性行为者HIV暴露前预防用药现状及相关因素分析

目的了解我国MSM对HIV暴露前预防(PrEP)的认知和用药现状及影响因素。方法 2021年8月25日至9月5日通过男性社交平台Blued 7.5软件在我国24个城市招募MSM 2 447人参与线上问卷调查, 调查内容包括社会人口学、PrEP知晓和用药与高危性行为等信息。采用三分类二水平logistic回归分析MSM的PrEP用药相关因素。采用SPSS 24.0和SAS 9.4软件进行统计学分析。结果在MSM研究对象2 447人中, 听说过PrEP者1 712人(69.96%), 曾用药者437人(17.86%), 正在用药者274人(11.20%), 停用者163人(6.66%);437人曾用药者多数采用了按需用药方式, 用药方案采用替诺福韦+恩曲他滨的占61.88%(388/627), 人均用量为1.12片/周, 获取药物以互联网为主, 选择药物更关注PrEP用药的预防效果;163人停药最常见原因是认为没有HIV感染的风险。logistic回归分析结果显示, MSM中PrEP用药与年龄、月均收入、最近1年发生无保护肛交、最近1年使用助性剂和被诊断出患有性病等因素存在统计学关联, 其...     

Is HIV prevention creating new biosocialities among gay men? Treatment as prevention and pre‐exposure prophylaxis in Canada

The advancements of “treatment as prevention” (TasP), “undetectable viral load” (UVL) and “pre‐exposure prophylaxis” (PrEP) are redefining HIV prevention standards. Relying on the concept of biosociality, this article explores how gay men rally around, debate, and sometimes disagree about these emerging HIV prevention technologies. This article is based on data from the Resonance Project, a Canadian community‐based research project. Twelve focus groups (totalling 86 gay and bisexual men) were held in three Canadian cities (Montreal, Toronto, Vancouver) in 2013–2014. Respondents view UVL and PrEP through the prism of their generational experience of HIV prevention. In this respect, biosocialities highlight an experiential dimension that is tied to the context of the HIV epidemic. The biosocialities of HIV prevention are also built around serological identities. However, our study shows the diversity of these positions. Analysis grounded in biosocialities is useful for better understanding how scientific information circulates, is made sense of, and generates debate among gay men.     

2010－2013年中国男男性行为人群艾滋病/梅毒感染状况、性行为特征及艾滋病知识知晓情况的Meta分析

目的 通过2010－2013年针对MSM人群的调查进行Meta分析,了解近年来中国MSM人群的性行为特征、艾滋病知识知晓率情况、HIV/梅毒的感染状况及其随时间和地区的分布。方法 检索中国期刊全文数据库(CNKI)、万方数据库、PubMed数据库上已发表的2010－2013年针对中国MSM人群HIV、梅毒感染状况的文献,采用Stata 12.0软件对入选文献进行Meta分析。结果 共有66篇文献纳入,2010－2013年中国MSM人群中HIV合并感染率为7.7%(95%CI:7.2%～8.3%),呈逐年上升趋势,其中西南地区合并HIV感染率最高(12.0%);合并梅毒感染率为10.9%(95%CI:9.8%～12.1%),华南地区合并梅毒感染率最高(14.4%);性行为特征呈现近6个月肛交发生率偏高(84.2%),肛交坚持使用安全套率较低(44.8%)的特点,但该人群有较高的艾滋病知识知晓率(88.4%)。结论 2010－2013年中国MSM人群HIV、梅毒感染疫情呈高流行态势,面对该人群“高艾滋病知识知晓率,高无保护性性行为”这一普遍现象,探求有效促进MSM人群安全套使用的综合干预策略,减少“知行分离”的发生尤为重要。     

云南省男男性行为者HIV暴露前预防用药意愿及相关因素分析

目的分析云南省男男性行为者HIV暴露前预防(PrEP)用药意愿及影响因素。方法采用横断面研究设计, 通过滚雪球抽样方法在2021年4-6月云南省14个城市(自治州)开展调查。国家级哨点样本量为400人, 省级哨点样本量为100人。采用logistic回归分析PrEP用药意愿的相关因素。使用SPSS 22.0软件进行统计学分析。结果共调查MSM 2 450人, 听说过PrEP的比例为68.5%(1 677/2 449), 愿意PrEP用药的比例为56.7%(1 343/2 368), 愿意自费PrEP用药的比例为30.6%(724/2 368), 愿意免费PrEP用药的比例为56.2%(1 330/2 367)。多因素logistic分析结果显示, PrEP用药意愿低的相关因素包括40～和≥50岁(aOR=2.49和aOR=4.48)、汉族(aOR=1.47)、外省户籍(aOR=1.64)、高中/中专(aOR=1.96)与大专及以上文化程度(aOR=3.49)、样本来源分别为浴池/桑拿(aOR=3.53)、网络招募(aOR=2.53)和自愿咨询与检测(aOR=1.42)、本地居住时间3～...     

江苏省男男性行为人群HIV和梅毒感染状况及影响因素研究

目的 了解江苏省男男性行为人群（men who have sex with men,MSM）人类免疫缺陷病毒（human immunodeficiency virus,HIV）和梅毒感染状况及影响因素。方法 2015年在江苏省8个地级市招募MSM,并进行问卷调查及实验室检测,采用多因素Logistic回归模型分析HIV和梅毒感染的影响因素。结果 2 451名MSM的HIV感染率为10.3%,梅毒现症感染率为8.3%。多因素分析结果显示:40岁及以上、网络招募、最近6个月发生无保护性肛交（unprotected anal intercourse,UAI）、最近一年未接受过HIV检测及正在感染梅毒是MSM人群感染HIV的主要危险因素（均有P<0.05）;25岁及以上、初中及以下文化程度、场所招募及最近6个月发生UAI是MSM人群感染梅毒的主要危险因素（均有P<0.05）。结论 江苏省MSM人群HIV感染持续呈高水平状况,梅毒现症感染得到控制。促进安全套使用和HIV/梅毒检测应持续成为MSM人群性病艾滋病防治的重要工作。     

不同活动场所男男性行为人群HIV检测比例及影响因素分析

目的了解酒吧、露天公园和浴池等不同活动场所的男男性行为人群（men who have sex with men,MSM）既往HIV检测比例及其影响因素。方法选取在郑州市和成都市MSM活动的酒吧、露天公园和浴池,采用问卷调查和现场拦截调查对在场所内活动的MSM进行调查。结果共调查554名符合纳入标准的研究对象,其中377人（68.1%）既往做过HIV检测,331人（59.7%）在最近1年检测过HIV。多因素Logistic分析结果显示,身边有做过HIV检测的朋友、知晓调查地区MSM人群HIV感染率、最近1年接受过艾滋病预防干预服务、最近6个月与男性固定性伴肛交时安全套的使用频率是场所活动的MSM人群HIV检测的影响因素。结论两城市在场所活动的MSM人群HIV检测比例达到了一定的水平,应继续发挥MSM社区小组在场所开展促进HIV检测工作中的作用,并将当地MSM疫情加入HIV检测宣传中,以进一步提高场所MSM人群的HIV检测比例。     

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1 222例MSM研究对象,年龄（31.5±...     

大学生男男性行为者对艾滋病暴露前预防知识知晓及其影响因素

目的 了解我国大城市大学生MSM对艾滋病暴露前药物预防（PrEP）知识知晓情况及其影响因素。方法 采用网上问卷调查方式收集北京、深圳、昆明三市的大学生中男男性行为者（MSM）的基本情况、行为学特征、艾滋病防治知识知晓、PrEP知识知晓情况,并以PrEP知识知晓为因变量,进行单因素和logistic回归模型多因素分析。结果 共调查293名大学生MSM,平均年龄为21.0(20.8～21.2)岁,本科生占91.1%。调查对象中男性伴数多于1个者占38.9%,每次性行为都使用安全套者占68.0%,近一年内29.4%未进行HIV检测。大学生MSM中艾滋病防治知识知晓率为 92.2%(270/293),PrEP知识知晓率为34.5%,74.7%听说过PrEP; 53.6%认为PrEP作用是预防HIV,73.7%认为接受PrEP同时要使用安全套。多因素分析结果显示,近3个月每次同性行为使用安全套（OR=3.394,95% CI:1.179～9.773),近一年内HIV检测次数大于2次（OR=2.181.95% CI:1.062～4.479）是大学生MSM知晓PrEP的影响因素。结论 大学生对于PrEP的正确认知仍不足,但出于对自身健康的关心,能主动获取PrEP相关的知识和信息,应结合高校内艾滋病防治知识宣传和健康教育,进行PrEP知识宣传和健康教育。     

珠三角地区2009－2013年男男性行为者HIV感染率及其影响因素分析

目的 了解珠三角地区MSM的HIV感染状况及其影响因素。方法 2009－2013年采用全国MSM哨点监测方案调查该地区内6市MSM的HIV感染率,并分析影响因素。结果 2009－2013年珠三角地区6市共调查MSM 8 770例,HIV感染率分别为4.7%、9.7%、10.6%、12.9%和11.4%,呈上升趋势。MSM中危险行为较为普遍,最近6个月肛交每次使用安全套的比例为46.3%。年龄较大、外省籍、不坚持使用安全套、1年内被诊断患过性病及1年内未接受过艾滋病相关干预服务,是该人群感染HIV的危险因素。结论 珠三角地区MSM中HIV传播危险行为较为普遍,HIV感染率呈逐年上升趋势。     

Facebook network structure and awareness of preexposure prophylaxis among young men who have sex with men

BackgroundYoung Black men who have sex with men (YBMSM) are the only population in the United States who have experienced rising human immunodeficiency virus incidence over the past decade. Consistent pre-exposure prophylaxis (PrEP) use can substantially reduce the risk of human immunodeficiency virus acquisition. What differentiates those who become aware of PrEP, and those who do not, remains largely unknown.MethodsThe social networks of YBMSM can impact their awareness of PrEP; to examine this impact, we used two waves of Facebook data from “uConnect”–a longitudinal cohort study of YBMSM in Chicago (n = 266).ResultsWhile PrEP awareness increased from 45% at baseline to 75% at follow-up, its use remained low (4% and 6%). There were 88 PrEP-unaware individuals at baseline who became aware (BA) by follow-up, and 56 who remained persistently unaware. While the persistently unawares had a higher median number of total Facebook friends, the BAs had a higher median numbers of friends who participated in uConnect, who were PrEP-aware, and who practiced behaviors previously found to be associated with individual-level awareness of PrEP at baseline. The BAs also had substantially more “influential” friends.ConclusionThese findings demonstrate the potential of social networks in raising PrEP awareness and use among YBMSM.     

Risk behaviours and HIV infection among men having sexual relations with men: baseline characteristics of participants in the Omega Cohort Study, Montreal, Quebec, Canada

OBJECTIVE: To describe characteristics of men having sex with men (MSM) participating in the Omega Cohort, to describe HIV-positive participants at baseline interview, and to estimate HIV incidence. METHODS: The Omega Cohort is a study on the incidence and psychosocial determinants of HIV infection among MSM living in Montreal. MSM complete a questionnaire and are tested for HIV every six months. RESULTS: During the previous six months, 31% and 12% of 810 participants (mean age = 33 years) reported unprotected anal sex with regular and casual partners, respectively. Eight participants (0.98%) were HIV-infected at baseline. HIV incidence was 0.89 per 100 person-years (7/787 person-years) [95% confidence interval: 0.36-1.83]. CONCLUSION: A significant proportion of participants reported current risk behaviours. Despite this, HIV incidence is relatively low. It is important to target MSM who do not practice safe sex and to encourage those practicing safe sex to sustain these behaviours.     

重庆地区男男性行为人群多性伴行为特征及影响因素

  目的   了解重庆地区艾滋病病毒(human immunodeficiency virus, HIV)阴性多性伴肛交(≥5人)男男性行为者(men who have sex with men, MSM)的人口学和性行为特征及其影响因素。   方法   从2018年6月至2019年6月, 招募重庆地区319名HIV阴性MSM, 收集其人口学特征、近半年内安全套使用率、是否感染性病、性角色、药物滥用史、是否服用过暴露后预防(post-exposure prophylaxis, PEP)药物、是否关注HIV知识和是否服用过暴露前预防(pre-exposure prophylaxis, PrEP)药物等信息。采用单因素和多因素Logistic回归分析模型分析MSM人群多性伴肛交的影响因素。   结果   319名HIV阴性MSM中, 34.5%(110/319)近6个月内性伴人数≥5人; 110名多性伴MSM中, 63.6%(70/110)年龄≤28岁, 75.4%(83/110)学历为大学本科或大专; 50名报告情感状况的MSM中, 72.0%(36/50)为单身。多因素Logistic回归分析模型分析显示, 服用过PEP药物和经常关注HIV知识是MSM多性伴肛交的主要影响因素。   结论   重庆地区HIV阴性MSM人群普遍存在多性伴肛交现象。应加大对MSM人群, 尤其是低龄MSM人群, HIV防治知识的宣教力度。在推广PrEP和PEP在MSM人群中的使用时, 应警惕其相关风险补偿。     

HIV Pre-Exposure Prophylaxis,Condoms, or Both? Insights on Risk Compensation Through a Discrete Choice Experiment and Latent Class Analysis Among Men Who Have Sex With Men

ObjectivesWe considered how decision making around human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among gay, bisexual, and other men who have sex with men (GBMSM) is made in the context of one’s perceived risk of HIV acquisition and the availability of condoms.MethodsWe recruited 648 GBMSM aged 18 years old and residing in Singapore through Grindr. Participants were given information on PrEP and participated in a discrete choice experiment requiring them to choose between 2 baskets of PrEP attributes and compare the chosen “PrEP only” option to default options of “condoms only” or “PrEP with condoms.” Generalized multinomial logit model was used to examine the scaling effect and preference heterogeneity. Latent class analysis was conducted to examine preference heterogeneity in the sample.ResultsLatent class analysis revealed 3 classes of GBMSM: PrEP conservatives (53.9%), moderates (31.1%), and liberals (14.9%). PrEP conservatives were more likely to report greater utility when using condoms only compared with PrEP only, as well as PrEP with condoms, compared with PrEP only, and more likely to report the lowest utility for PrEP as perceived HIV risk increased. PrEP liberals were more likely to report greatest utilities for PrEP only compared with condoms only, as well as PrEP only compared with PrEP with condoms. The utility for PrEP was not affected by perceived risk of HIV or sexually transmitted infections when risks were low.ConclusionThis study provides some evidence for risk compensation among a class of GBMSM who already perceived themselves to be good candidates for PrEP before the discrete choice experiment.     

Experiences of men who have sex with men when initiating,implementing and persisting with HIV pre‐exposure prophylaxis

IntroductionHIV pre‐exposure prophylaxis (PrEP) involves the use of antiretroviral medication in HIV‐negative individuals considered to be at risk of acquiring HIV. It has been shown to prevent HIV and has been available in Wales since July 2017. Measuring and understanding adherence to PrEP is complex as it relies on the simultaneous understanding of both PrEP use and sexual activity. We aimed to understand the experiences of men who have sex with men (MSM) living in Wales initiating, implementing and persisting with HIV PrEP.MethodsWe conducted semistructured interviews with MSM PrEP users in Wales who participated in a cohort study of PrEP use and sexual behaviour. Following completion of the cohort study, participants were invited to take part in a semistructured interview about their experiences of taking PrEP. We aimed to include both individuals who had persisted with and discontinued PrEP during the study. The interview topic guide was informed by the ABC taxonomy for medication adherence and the theory of planned behaviour. We analysed our data using reflexive thematic analysis.ResultsTwenty‐one participants were interviewed, five having discontinued PrEP during the cohort study. The developed themes focused on triggers for initiating PrEP, habitual behaviour, drivers for discontinuation and engagement with sexual health services. Stigma surrounding both PrEP and HIV permeated most topics, acting as a driver for initiating PrEP, an opportunity to reduce discrimination against people living with HIV, but also a concern around the perception of PrEP users.ConclusionThis is the first study to investigate PrEP‐taking experiences incorporating established medication adherence taxonomy. We highlight key experiences regarding the initiation, implementation and persistence with PrEP and describe how taking PrEP may promote positive engagement with sexual health services. These findings may be useful for informing PrEP rollout programmes and need to be explored in other key populations.Patient and Public ContributionPrEP users, in addition to PrEP providers and representatives of HIV advocacy and policy, were involved in developing the topic guide for this study.     

应用传染病动力学模型预测“三个90%”目标与暴露前预防用药对我国男男性行为人群消除艾滋病的影响

目的 通过构建传染病动力学模型,预测2018－2037年扩大HIV检测和治疗与暴露前预防用药（pre-exposure prophylaxis,PrEP）对我国MSM人群艾滋病流行趋势和消除的影响。方法 构建我国MSM人群中的传播动力学模型,通过文献查阅收集模型运行所需的输入参数及校准参数。运用MATLAB 7.0软件将模型参数及微分方程进行编程和计算,分析HIV在MSM人群中的传播规律,探讨扩大HIV检测和治疗与PrEP的组合措施对该人群消除艾滋病的影响。结果 在现有政策下,我国2018－2037年MSM人群HIV新发感染人数将达77万人。到2037年HIV感染率将达到11.1%,发病率达到0.72/100人年。采用扩大HIV检测与治疗措施后,2018－2037年将减少44万（即减少57.7%）的HIV新发感染,到2037年该人群的HIV感染率下降至5.7%,HIV发病率下降到0.24/100人年,但无法达到消除艾滋病目标。采用“三个90%”目标与PrEP组合干预措施,当PrEP依从性为100%时,未来10、15和20年内达到消除艾滋病目标,高风险MSM人群的PrEP覆盖率需分别为65%、32%、19%。结论 我国应对MSM人群继续扩大艾滋病的检测和治疗,提高PrEP依从性和覆盖率,以控制及消除MSM人群艾滋病的流行。     

北京市男男性行为者HIV新发感染率与高危行为及接受暴露前后预防用药服务情况调查

目的 了解北京市MSM的HIV新发感染率与高危行为及接受暴露前后预防（PrEP/PEP）用药服务情况。方法 采用Epi Info7.0软件计算参加横断面调查和队列调查样本量分别为1 227人和207人年。采用方便抽样法通过手机微信公众号招募MSM参加自填式网络问卷调查，收集其社会人口学、高危行为及接受PrEP/PEP用药服务利用情况，MSM自行采集干血斑样本邮寄到指定实验室进行HIV核酸检测。建立HIV核酸阴性受检者开放式队列，随访观察至研究终点。采用非条件logistic回归分析MSM最近1个月无保护肛交行为、最近1个月同性多性伴的影响因素。结果 共招募MSM 1 147人，其中HIV核酸阴性者956人观察236人年。HIV新发感染率为1.3/100人年（3/236）。最近1个月肛交和口交每次都使用安全套者分别占50.7%（238/469）和4.9%（23/469）。最近1个月与HIV感染者发生性行为的比例为5.9%（43/723）。分别有9.8%（103/1 049）和8.7%（91/1 049）的研究对象曾接受PrEP/PEP用药服务。PrEP/PEP用药期间发生性行为每次使用安全套的比例分别为34.3%（24/70）和72.2%（39/54）。多因素logistic回归分析结果显示，接受PrEP/PEP用药服务者的最近1个月发生无保护肛交行为和有同性多性伴的可能性均较高（aOR=3.16，95%CI：1.45~7.18；aOR=2.64，95%CI：1.19~6.30）；最近1个月使用毒品或Rush Popper者的最近1个月发生无保护肛交行为和有同性多性伴的可能性均较高（aOR=2.34，95%CI：1.67~3.30；aOR=2.42，95%CI：1.76~3.33）。结论 应在MSM中倡导坚持使用安全套及开展常见滥用药物危害的健康教育。在PrEP/PEP用药服务咨询中，需提示MSM坚持使用安全套的重要性。