Investigation On The Willingness And Influencing Factors Of Post-exposure Prophylaxis For Men Who Have Sex With Men After HIV Exposure In Two Places In Yunnan Province

Objective:To understand the acquired immunodeficiency syndrome(AIDS)awareness rate,related behaviors,post-exposure prophylaxis(PEP)acceptability and related influencing factors of men who have sex with men(MSM)in Kunming city and Kaiyuan city,Yunnan Province,and obtain the baseline data related to PEP service of MSM in Yunnan Province,so as to provide scientific basis for reducing human immunodeficiency virus(HIV)infection among MSMMethods:Cross-sectional study was conducted from May to December 2019,through snowball rolling and convenient sampling,a face-to-face questionnaire survey was carried out among MSM in Kunming and Kaiyuan cities in Yunnan Province by community organizations.The sample size in Kunming City was 400,and that in Kaiyuan City was 200,with a total sample size of 600.Questionnaire was designed by reference "HIV sentinel surveillance protocol in yunnan province " developed by Yunnan Center for Disease Control and Prevention,compiled with "the people health male behavior questionnaire" and the Aaron diamond AIDS research center Pre-exposure prophylaxis project questionnaire design,including general demographic characteristics,knowledge about HIV/AIDS,characteristic and the knowledge of the PEP,sexual behavior,PEP use intention,etc.In addition,qualitative investigation was carried out on MSM who did not take remedial measures to take PEP in time after high-risk behaviors,and 20 to 30 minutes of individual in-depth interviews were conducted in an independent space in the form of face-on-face.Epidata3.1 was used for data entry and SPSS22.0 for statistical analysis.Results:1 Quantitative studyA total of 600 questionnaires were completed,of which 580 were valid,with an effective rate of 96.7%.A total of 30 people were interviewed for qualitative research.Basic demographic characteristics:1.1The respondents aged 18-65(28.4±10.5),residence in Yunnan Province accounted for 79.7%(462/580),the han nationality accounts for 70.3%(408/580),married people accounted for 80.7%(468/580),high school education above accounted for 74.1%(430/580),local residence time more than two years in the industry accounted for 77.9%(452/580),monthly income lower than 3000 yuan accounting for 55.0%(319/580).1.2 Knowledge of AIDS:the awareness rate of AIDS among the respondents was92.4%(536/580).1.3 PEP awareness:55.5%(322/580)have heard of PEP,among them,47.8%(153/322)have heard of PEP through healthcare workers or community organizations,38.5%(124/322)have learned about PEP through social software,and 98.1%(569/580)have never used PEP.4.MSM sexual orientations:52.6%(340)of the respondents were gay,and 36.6%were bisexual.for the first time of same sex have a sex less than 20 years old(387/580).sex role was "0.5" accounting for 42.6%(247/580).1.5 Influencing factors of PEP acceptability:83.8%(486/580)were willing to take PEP after high-risk behaviors.There are 9 single factors affecting the acceptability of PEP:Level of education(χ2=12.571,P=0.002),pro fession(χ2=9.410,P=0.002),monthly income(χ2=20.769,P<0.001),sex role(χ2=10.459,P=0.005),have you used condoms during the last six months of same-sex sex(X2=5.211,P=0.022),using a condom at last same-sex sexual encounter(χ2=5.600,P=0.018),is it difficult to prevent HIV at present(χ2=5.413,P=0.020),whether there is a risk of HIV infection in the next five years(χ2=12.571,P=0.002),have you ever heard of PEP(χ2=5.334,P=0.021)。The significant factors of multivariate Logistic analysis are:education level(OR=0.056,95%CI=0.330～0.951);whether it is difficult to prevent HIV at present(OR=0.606,95%CI=0.373-0.985);have you ever heard of PEP(OR=1.933,95%CI=1.192～3.136);Sex role(reference group:sex role was"0.5"):sex role was "1"(OR=0.547,95%CI=0.317-0.945),sex role was "0"(OR=0.474,95%CI=0.251-0.895).The most recent use of a condom during same-sex sex(OR=2.225,95%CI=1.211～4.089).2 Qualitative studyThirty MSM aged between 19 and 54 were interviewed.Most interviewers have sexual partners at a certain time,and the condom using frequecy is not high.The main reasons unwilling to use condom are multiple sexual behaviors with one person,affecting sexual sensitivity,judgeing their health status according to the external conditions of sexual partners,etc.Most interviewers who did not accept PEP did not have knowledge about PEP,the cost of prophylactic drugs,etc.Most interviewers believe that PEP will not affect future sexual behavior.The expectation of PEP is that the price of preventive medicine can be reduced less than 500 yuan,and additional PEP service agencies are set up to promote PEP services in MSM.Conclusion:The awareness of PEP among MSM in Yunnan Province is at an intermediate level in China.After high-risk behaviors,the acceptability of PEP is relatively high.The acceptability of PEP is mainly affected by the awareness of PEP,the education level,the sexual role,the use of condoms at last same-sex sexual behavior and other factors.It is suggested to enhance the health education of PEP,improve the related services of PEP and reduce the HIV infection as much as possible.