Study Of Risk Compensation After HIV Pre-exposure Prophylaxis Among Men Who Have Sex With Men

Objective: Develop pre-exposure prophylaxis(PrEP)among men who have sex with men(MSM),and find potential risk compensation and time of occurrence,provides the value to avoid risk compensation.Methods: Cooperating with nongovernmental organizations(NGO)and use their office as a research field,with non-probabilistic sampling method recruit MSM through the network and the propaganda,then recruit into the group according to inclusion criteria and sign a consent form.In accordance with the subjects are divided into take a daily Tenofovir(Group A),sex act-dependent oral regimens(Group B),and placebo(Group C).Filling out a baseline questionnaire about demographic,HIV/AIDS knowledge and sexual behaviors and so on,then to follow up for every 12 weeks finish a questionnaire including adherence and sexual behaviors.All participants received HIV testing,brief lient-centered counseling,and clinical monitoring from August 2013 end to December 2015.Carries on the comparative analysis between the three groups by baseline questionnaire.Through generalized estimating equations of repetitive measurements of follow-up information were analyzed,and finally evaluate risk compensation.Results: 1.In this study recruited 600 participants,out of 73 people,527 participants are recruited into the baseline,group A for 142 people(26.9%),group B for 208 people(39.5%),group C for 177 people(33.6%).There are similar in the demographic,AIDS related knowledge,risk perception and sexual behavior of the three group in the baseline.During follow-up,with the extension of time the adherence were increased,but there were HIV infections under low adherence in the early stage of the experiment,and found that sexual behavior is a risk factor for HIV infection,suggesting that it is necessary to find risk compensation.2.Risk compensation analysis:with the extension of time,the number of sexual partners and anal sex sex increases and the difference was statistically significant after 48 weeks(?2=11.594,P<0.001,?2=5.443,P=0.020).But the rate of anal sex condom use was reduced during the 60 weeks(?2=4.090,P=0.043).There was no risk compensation for oral sex and condom use.With the extension of time to 48 weeks HIV risk perception was gradually reduce.3.After PrEP there are 22.8% MSM who had happened risk compensation,and people who is minority(OR=4.98,95%CI:2.02~12.28),married(OR=2.96,95%CI:1.19~7.34)and monthly income below 3000 yuan(OR=5.10,95%CI:1.96~13.24)prone to occure risk compensation.Conclusion: The participant prone to occure risk compensation after PrEP especially after a year,suggesting that this is an important time to prevent.With the highlight of PrEP would increase the high risk sexual behavior and reduce condom use.It's necessary to promote the traditional way of prevention and offer risk consult among MSM.Instilling the idea of joint prevention for MSM,and avoid the risk compensation.