Abstract:Objective To investigate the factors affecting pre-exposure prophylaxis (PrEP) use among men who have sex with men (MSM), so as to provide a basis for improving PrEP uptake among MSM and optimizing HIV prevention and control strategies. Methods The MSM were recruited at a HIV testing site of the "Danlan Public Welfare" organization in Beijing Municipality using the convenient sampling method from March to May 2024. Sociodemographic information, awareness of basic AIDS knowledge, sexual orientation and behaviors, the use of PrEP and post-exposure prophylaxis (PEP) in the past six months were collected using the questionnaire survey. Multivariable logistic regression model and decision tree model were used to analyze the influencing factors for PrEP use among MSM. Results A total of 414 participants were surveyed, with a mean age of (33.52±8.50) years. Among them, 345 individuals (83.33%) had a college degree and above. The predominant sexual orientation was homosexual, with 265 individuals, accounting for 64.01%. The majority reported having 1 to 2 same-sex partners in the past six months, with 182 individuals (43.96%). A total of 39 individuals (9.42%) had used PEP in the past six months. A total of 68 individuals (16.43%) had used PrEP during the same period. Multivariable logistic regression analysis revealed that educational attainment (college degree and above, OR=28.200, 95%CI: 3.162-251.519), the number of same-sex partners in the past six months (3-5 partners, OR=3.963, 95%CI: 1.065-14.755; ≥6 partners, OR=7.518, 95%CI: 1.829-30.910), and the use of PEP in the past six months (OR=18.606, 95%CI: 7.587-45.631) were significant factors associated with PrEP use among MSM. The decision tree model identified educational level, sexual orientation, and the number of same-sex partners in the past six months as factors affecting PrEP use among MSM. Among these, the number of same-sex partners in the past six months emerged as the primary influencing factor. The use of PrEP was 38.46% among MSM who had ≥3 same-sex partners in the past six months and identified as homosexual or heterosexual. Conclusion The use of PrEP among MSM is primarily associated with educational level, the number of same-sex partners in the past six months, use of post-exposure prophylaxis (PEP) in the past six months, and sexual orientation.
李欣格, 王丽娟, 宋亮, 丁海峰, 高彦杰. 男男性行为人群暴露前预防使用的影响因素分析[J]. 预防医学, 2025, 37(12): 1201-1205.
LI Xinge, WANG Lijuan, SONG Liang, DING Haifeng, GAO Yanjie. Factors affecting pre-exposure prophylaxis use among men who have sex with men. Preventive Medicine, 2025, 37(12): 1201-1205.
[1] 潘蕴蛟,林丽,吴守丽,等.艾滋病暴露前预防用药技术推广应用的伦理困境及对策[J].医学与哲学,2024,45(21):40-43. PAN Y J,LIN L,WU S L,et al.Ethical dilemmas and countermeasures in the promotion and application of HIV pre-exposure prophylaxis technology[J].Med Philos,2024,45(21):40-43.(in Chinese) [2] World Health Organization.Global state of PrEP[EB/OL].[2025-11-24] .https://www.who.int/groups/global-prep-network/global-state-of-prep. [3] 夏冬艳,苏雪丽,刘国武,等.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[J].中华流行病学杂志,2023,44(9):1390-1396. XIA D Y,SU X L,LIU G W,et al.Investigation on new HIV infection rate,high-risk behavior and preventive drug service before and after exposure among men who have sex with men in Beijing[J].Chin J Epidemiol,2023,44(9):1390-1396.(in Chinese) [4] 张路坤,王辉.中国HIV暴露前预防用药专家共识(2023版)[J].中国艾滋病性病,2023,29(9):954-961. ZHANG L K,WANG H.Expert consensus on preventive medication before HIV exposure in China(2023 edition)[J].Chin J AIDS STD,2023,29(9):954-961.(in Chinese) [5] 马丽娟. 我国艾滋病防治督导与评估系统能力评价研究[D].合肥:安徽医科大学,2013. MA L J.Research on capability evaluation of AIDS prevention and control supervision and evaluation system in China[D].Hefei:Anhui Medical University,2013.(in Chinese) [6] PENG Q L,LIU X N,TANG X,et al.Low rate of pre-exposure prophylaxis and post-exposure prophylaxis uptake and high prevalence of transmitted drug resistance among newly diagnosed primary HIV infections in Shenzhen,China:a real-world retrospective study[J].Chin Med J,2022,135(22):2730-2737. [7] 李翔,赵宇博,任强,等.陕西省男男性行为人群HIV暴露前预防药物的知晓、使用意愿及使用现状分析[J].中华流行病学杂志,2024,45(12):1679-1684. LI X,ZHAO Y B,REN Q,et al.Awareness,willingness,and status of using HIV pre-exposure prophylaxis among men who have sex with men in Shaanxi Province[J].Chin J Epidemiol,2024,45(12):1679-1684.(in Chinese) [8] HOLLOWAY I W,TAN D E,GILDNER J L,et al.Facilitators and barriers to pre-exposure prophylaxis willingness among young men who have sex with men who use geosocial networking applications in California[J].AIDS Patient Care STDS,2017,31(12):517-527. [9] GUO J H,KANG W T,LIU T T,et al.Analysis of knowledge level and use of antiretroviral pre-exposure and post-exposure prophylaxis among MSM - China,2019-2022[J].China CDC Weekly,2023,5(13):292-296. [10] MACAPAGAL K,KRAUS A,KORPAK A K,et al.PrEP awareness,uptake,barriers,and correlates among adolescents assigned male at birth who have sex with males in the U.S[J].Arch Sex Behav,2020,49(1):113-124. [11] BLAIR K J,TORRES T S,HOAGLAND B,et al.Moderating effect of pre-exposure prophylaxis use on the association between sexual risk behavior and perceived risk of HIV among Brazilian gay,bisexual,and other men who have sex with men:cross-sectional study[J/OL].JMIR Public Health Surveill,2023[2025-11-24] .https://doi.org/10.2196/45134. [12] YEO T E D.Reconciling intimacy and safety:a qualitative systematic review of HIV pre-exposure prophylaxis implementation among gay and bisexual men[J].Cult Health Sex,2024,26(7):952-967. [13] LUO R,XIE Z,SILENZIO V M B,et al.Gay app use,sexuality traits,and high-risk sexual behaviors among men who have sex with men in China:mediation analysis[J/OL].J Med Internet Res,2023,25[2025-11-24] .https://doi.org/10.2196/49137. [14] 何佳晋,居豪,吴超,等.中国MSM人群HIV新发感染率及其影响因素的Meta分析[J].预防医学,2022,34(1):70-77. HE J J,JU H,WU C,et al.Meta-analysis of new HIV infection rate and its influencing factors among MSM in China[J].China Prev Med J,2022,34(1):70-77.(in Chinese) [15] WANG H Y,SHOBOWALE O,DEN DAAS C,et al.Determinants of PrEP uptake,intention and awareness in the Netherlands:a socio-spatial analysis[J/OL].Int J Environ Res Public Health,2022,19(14)[2025-11-24] . https://doi.org/10.3390/ijerph19148829. [16] LIU Y Y,SIDDIQI K A,CHO H,et al.Demographics,trends,and clinical characteristics of HIV pre-exposure prophylaxis recipients and people newly diagnosed with HIV from large electronic health records in Florida[J].AIDS Patient Care STDS,2024,38(1):14-22. [17] 夏永玲,张海芳,陶桃,等.丽水市MSM人群HIV定期检测及暴露后预防调查[J].预防医学,2024,36(6):465-469. XIA Y L,ZHANG H F,TAO T,et al.Regular HIV testing and post-exposure prophylaxis among men who have sex with men in Lishui City[J].China Prev Med J,2024,36(6):465-469.(in Chinese)