Study On The Demand For Non-occupational Post-exposure Prophylaxis To Preventing HIV Infection And Its Associated Factors Among MSM In Guangxi

ObjectiveTo assess the demand for non-occupational post-exposure prophylaxis(nPEP)to prevent HIV infection and its associated factors among men who have sex with men(MSM)in Guangxi.MethodsThrough cross-sectional studies,qualitative and quantitative methods were used to collect data.Personal in-depth interviews with 25 key informants of MSM were conducted to understand their perceptions,needs and suggestions for nPEP.Face to face an interviewer administrated questionnaire was used to collect the information from 344 subjects,including demographic characteristics,HIV/AIDS related knowledge,high risk behavior,utilization of HIV prevention services,the demand for nPEP,etc.Thematic Data Analaysis was used to analyze qualitative data.Descriptive statistics were used to describe the demographic characteristics,HIV/AIDS related knowledge,high risk behavior,awareness of nPEP,the demand for nPEP,etc.Chi-square test was used to analyze the nPEP demand by different characteristics of the respondents.Variables which is statistically significant in univariate analysis and the variables which might be meaningful in practical work were treated as independent variables,whether or not need nPEP was treated as the dependent variable,to assess risk factors associated with nPEP demand by Logistic regression,using odds ratio(OR)and its 95%confidence interval(CI)with p-value<0.05 for the difference was statistically significant.Results1 Qualitative interviews:the average age of the 25 interviewees was 31 years.The risk of non-occupational exposure to HIV was prevalent among MSM.Most of the interviewees stated that they have the demand for nPEP services.The factors that may affect the demand for nPEP include the awareness of local HIV/AIDS epidemic among MSM,the high risk sexual behavior,the cost of nPEP service,the side effects of nPEP drugs.Most interviewees suggested that nPEP service should be carried out and thought that nPEP service would not lead to an increase in risky behavior.2 Quantitative results:2.1 Demographic and behavioral characteristics:344 respondents,the median age was 26 years old,unmarried accounted for 82.3%(283/344),junior high school and higher education accounted for 87.2%(300/344),monthly income below 3000 yuan accounted for 66.6%(229/344).Only 57.6%(198/344)of the respondents used condoms for homosexual anal sex each time in the past six months.27.3%(94/344)of the respondents had experienced condoms accidentally ruptured,slipped,being deliberately pulled out or other dangerous sexual behavior.53.5%(184/344)of the respondents had the number of sexual partners for more than 2 and above in the past six months.5.2%(18/344)of the respondents used a new drug,there is no needle sharing drug users.2.2 Demand for nPEP services and its influencing factors:22.1%(76/344)of the respondents had heard of nPEP.60.2%(207/344)consider the demand for nPEP after understanding nPEP services.86.0%(296/344)of the respondents believe that nPEP services should be carried out among MSM.Univariate analysis showed that factors affecting the demand for nPEP include educational level,self-reported sexual orientation,monthly income level,the main sex role within half a year,fixed number of sexual partners within half a year,the awareness of local HIV/AIDS epidemic among MSM,the use of new drugs,whether worried about the side effects of nPEP drugs and whether care about the price of nPEP services.Multivariate logistic regression analysis showed that the factors affecting the demand for nPEP include fixed partners more than 3 within half a year[OR=8.12(95%CI:0.99-66.68)],feeling the HIV/AIDS epidemic among the local MSM is serious[OR=2.07(95%CI:1.14?3.73)],the level of monthly income or more than 3000 YUAN[OR=1.73(95%CI:1.05?2.85)],high education level[OR=0.23(95%CI:0.10?0.55)]and worried about the side effects of nPEP drugs[OR=0.41(95%CI:0.25?0.68)].2.3 Possible impact of nPEP on MSM risk behaviors:If the nPEP services are carried out anong MSM,only 8.4%(29/344)of respondents think that their condom use will be reduced,only 5.8%(20/344)of respondents think that their sexual partners will increase.Conclusion1 In some areas of Guangxi,the proportion of MSM who knew about nPEP services is low,but there is a higher demand for this service after understanding the nPEP service,and most subjects believe that nPEP services should be carried out among MSM.2 The factors that influence the demand for nPEP among MSM are monthly self-risk perception,the awareness of local HIV/AIDS epidemic among MSM,the price of drugs and side effects of drugs.3 As an effective biomedical intervention measure,nPEP should be carried out as soon as conditions permit in our country,to block HIV infection promptly after exposure,to provide more ways for AIDS prevention and control among MSM.4 We should give full play to the network media and the MSM community group strength to carry out publicity and referral.The nPEP services should be promote on the basis of exposure risk assessment in health professional institutions,such as hospitals and CDC.Reasonable nPEP prices should be formulated.To promote MSM proactive care seeking behavior,so that they can make timely use of nPEP services after HIV exposure occurs.While carrying out nPEP services,we should continue to strengthen public education and behavior interventions,such as encourage the reduction of risk behaviors,condom use,reducing the number of sexual partners,in order to reduce HIV infections among MSM.