Study On Influencing Factors Of Pre-Exposure Prophylaxis Compliance And It's Countermeasures In Men Who Have Sex With Men

Objective: Taking negative male sex as the research object,this paper has analyzed PrEP compliance of MSM population in west of China and the main influencing factors by the way of the construction of structural equation model(SEM)on compliance of pre-exposure prophylaxis(PrEP)in men who have sex with men(MSM)population on the bases of the theory of planned behavior(TPB).Methods: The MSM from Chongqing,Sichuan,Guangxi and Xinjiang in western China were asked anonymously by non-probability sampling method.The questionnaire mainly includes social demographic characteristics of the respondents and the four dimensions of the TPB:attitude toward the behavior,subjective norm,perceived behavioral control and behavior.Among them,the individual characteristics of MSM population,the comparison of PrEP compliance of MSM population with different socio-demographic characteristics,and the compliance status of the TPB and PrEP in all dimensions were analyzed by descriptive analysis method.Based on the TPB,through a SEM,quantitative analysis wasconducted on the each dimension influence in the TPB on the PrEP compliance,and the main factors affecting the PrEP compliance behavior were found out.Results: In this survey,831 MSM were actually included,and their average age was mainly between 30 and 40 years old.The majority of MSM were han nationality(90.97%)and urben household registration(74.73%).Among those who are employed(73.52%)and unmarried(74.61%),39.47% of them have a bachelor's degree or above,and only12.52% have an average monthly income of more than 5,000 yuan.Education level and employment status have significant influence on the comparison of PrEP compliance among MSM population(p<0.01).The dimensions of TPB: among attitude toward the behavior,90.49%of the MSM had a fear of AIDS,88.69% of the MSM had a positive attitude towards medication compliance,and 89.05% of the MSM worried about medication have no effects.In subjective norms,more than 58.12%of the MSM worried that their homosexual partners know that they were taking medications,70.88% of the MSM worried about being discriminated because others know that they are taking medications,93.03% of the MSM believed that doctors are friendly to them and cared about their health,and89.42% of the MSM trust doctors.67.51% of the MSM felt that taking medications was troublesome in their perceptual behavior control,and thedegree of MSM's unconfidence in PrEP compliance when the drank or used other drugs and did not get peer support was 39.82% and 42.95%,respectively.Once the MSM felt that the medications had side effects,the level of self-doubt increased to 63.89%.In the structural equation based on TPB,the model's GIF is greater than 0.9,while AGFI,PGFI,NFI and CFI are all within the acceptable range(0.7 ~ 0.9),so it can be considered that the model has a good adaptability.The standardized regression coefficients and the covariances between the latent variables in the model had statistical significance(p<0.05),among the 12 observational of the model,the squared multiple correlations of 6 was greater than 0.5,which indicated that the SEM based on TPB had a good explanatory ability in this study.The results of structural equation analysis showed that among the latent variables of TPB,perceived behavioral control had the largest influence on the PrEP compliance,and the direct effect size was 0.867;attitude towards the behavior and subjective norms directly affects the PrEP compliance,with the effect size of 0.417 and(-0.831),respectively.Conclusion: The results showed that perceived behavioral control is the most important factor affecting the PrEP compliance behavior of MSM,followed by subjective norm and attitude toward the behavior.So,when promoting PrEP compliance in MSM,we should focus on theseopportunities and resources: strengthen their psychological intervention,provide economic help from the government,family support,peer encourage,social health propaganda and education,through various measures to reduce the PrEP compliance of resistance encountered,for building a harmonious medical environment,improve their PrEP compliance,reduce new HIV infections.