The Acceptability And Influencing Factors Of Pre-exposure Prophylaxis Among Msm And Fsws In Guangxi

Objective To investigate the knowledge, attitudes, willingness to pre-exposure prophylaxis (PrEP) and its relative factors among MSM and FSWs in Guangxi, in order to provide reference to promote PrEP in local MSM and FSWs in the coming future. Methods Men who have sex with men (MSM) and female sex workers (FSWs) in HIV high-prevalence areas were surveyed through the conversation and asking face to face by the qualified trained investigators, the contents of questionnaire included social demographic characteristics of subjects such as the age, ethnicity, marital status; AIDS knowledge and attitudes, willingness to use PrEP and its influential factors. Subjects who chose the options "Certainly willing" were classified as the group that had the willingness to use PrEP, subjects who chose the options "Likely willing","Unclear","Likely not be willing" and "Certainly not be willing" were classified as the group that hadn’t the willingness to use PrEP, With Willing and unwilling as binary dependent variable, various factors that would affect the acceptance of PrEP were analyzed by The chi-square test and multivariate Logistic regression. Results650MSM and405FSWs in HIV high-prevalence areas were investigated.(1) The rate of willingness to use PrEP in MSM and FSWs in HIV high-prevalence areas was81.1%(527/650),68.4%(277/405) respectively. After The chi-square test analysis, the difference was statistically significant (χ2=34.927, P=0.000).(2) Variables which P value was less than0.10in univariate analysis were analyzed by multivariate Logistic regression model. It was found that in MSM,"Men who had sex behavior with women in six month"(oR=2.294,95%CI=1.132-4.650),"Ever heard microbicides"(OR=3.066,95%CI=1.462-6.431),"If HIV infection is high, will find a fixed partner, do not find casual partners"(OR=1.750),95%CI=1.096-2.792),"Consider it should be to promote PrEP"(OR=3.717,95%CI=1.694-8.157) were the favorable factors which affect their willingness to use PrEP;"Ever use drug to prevent HIV infection"(OR=0.223,95%CI=0.051-0.979) was the unfavorable factors which affect their willingness to use PrEP.(3) In FSWs,"The Han nationality"(OR=1.813,95%CI=1.112-2.956),"Consistent use of condoms"(OR=1.921,95%CI=1.103-3.344),"Ever use drug to prevent venereal diseases"(OR=4.006,95%CI=1.563-10.265),"Consider it should be to promote PrEP"(OR=5.157,95%CI=2.799-9.502) were the favorable factors which affect their willingness to use PrEP;"Less than28years old"(OR=0.588,95%CI=0.356-0.971),"Have a well family relationship"(OR=0.434,95%CI=0.238-0.788),"Monthly income less than3000yuan"(OR=0.373,95%CI=0.198-0.702),"Have client more than8per week"(OR=0.553,95%CI=0.324-0.944),"Offered the use of condoms"(OR=0.283,95%CI=0.107-0.749),"Ever heard post-exposure prophylaxis"(OR=0.305,95%CI=1.130-4.704) were the unfavorable factors which affect their willingness to use PrEP.(4) When people were asked how much would you paid for PrEP every month, the answer less than100yuan in MSM and FSWs was58%,54.6%respectively.(5) When people were asked the question If there were two types of drug, one was cheap but was Short medication interval, the other was expensive but was long medication interval, which type is your Preference? Chose type2in MSM and FSWs was46.7%,70.4%respectively. After The chi-square test analysis, the difference was statistically significant(χ2=50.590, P=0.000). FSWs prefer drug type2more than MSM. Conclusions (1) MSM had a better PrEP willingness than FSWs.(2) The demand of health was the common reason to accept PrEP; the safety, effectiveness and free of charge were the key influential factors of the willingness; In addition, other factors such as the social demographic characteristics and their AIDS knowledge, cognition of PrEP are more or less influential on their willingness to use PrEP.(3) If we want to promote PrEP in MSM and FSWs, we must offer safe, effectiveness and less side effects drug. Meanwhile, heath education might improve the acceptability of PrEP.(4) FSWs prefer the expensive but long medication interval drug than MSM.