MSM人群对HIV暴露前预防知识知晓及相关因素研究

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。

Knowledge awareness and its influencing factors of HIV pre-exposure prophylaxis among MSM

  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.