Investigation On Willingness And Influencing Factors Of Using HIV Pre-exposure Prophylaxis Among Men Who Have Sex With Men In Two Places In Yunnan Province

Objective:To explore the awareness of HIV pre-exposure prophylaxis(PrEP)and willingness of using PrEP and its influencing factors among men who have sex with men(MSM)in Kunming City and Kaiyuan City of Honghe Prefecture of Yunnan Province,in order to provide evidences for the further implementation of PrEP among MSM.Methods:A cross-sectional study was conducted in Kunming City and Kaiyuan City,from June to November,2018.A total of 600 MSM were recruited by using a non-probability sampling method and based on the MSM community working group to conduct face-to-face questionnaires.The questionnaire refers to the "Survey Questionnaire on the Health of Men Who Have Sex With Men" and the questionnaire design by Yunnan Center for Disease Control and Prevention.Also refers to the questionnaire of PrEP project design by The Aaron Diamond AIDS Research Center.The content of the questionnaire includes general demographic characteristics,knowledge of AIDS,personal sexual characteristics,and knowledge,attitude and willingness to use PrEP.At the same time,a qualitative interview was conducted on several MSM.The content of interview was focused on the methods to prevented HIV infection and the deep influencing factors of willingness of using PrEP.The data of questionnaire was collated using Epidata3.1,data analysis was conducted using spss 22.0,the single factor analysis used chi-square test,and the multi-factor analysis used logistic regression analysis.Results:A total of 600 quantitative questionnaires were completed,of which 596 were effective(99.3%effective).There was 276 MSM who had heard of PrEP,and the awareness rate was 46.3%.Univariate analysis of influencing factors of awareness includes,ethnic(χ2=51.134,P<0.001),age(χ2=44.137,P<0.001),household registration(χ2=29.314,P<0.001),the time living in local(χ2=8.676,P=0.003),educational level(χ2=73.178,P<0.001),occupation(χ2=25.559,P<0.001),monthly income(χ2=20.899,P<0.001),think it is difficult to prevent HIV(χ2=14.279,P<0.001),likely to be infected with HIV(χ2=5.134,P=0.023),somebody they know are infected with HIV(χ2=29.045,P<0.001),afraid of HIV(χ2=35.587,P<0.001),have the ability to prevent HIV(χ2=5.012,P=0.025),have heard of post-exposure prophylaxis(χ2=186.985,P<0.001)and have been tested for HIV(x2=26.256,P<0.001).Multivariate Logistic regression analysis of influencing factors include ethnic(OR=2.200,95%CI:1.283～3.774),educational level(OR=0.366,95%CI=0.231～0.579),afraid of HIV(OR=3.290,95%CI=1.883～5.750),think it is difficult to prevent HIV(OR=1.696,95%CI=1.075～2.677),have heard of post-exposure prophylaxis(OR=10.389,95%CI=6.339～17.027).Assuming that daily use of PrEP is at least 90%effective for HIV prevention,and it is free,64.4%(384/596)of the respondents are willing(including absolute and possible use)to use daily.There are 10 factors with statistical significance for univariate analysis,area of investigation(χ2=5.430,P=0.020)the time living in local(χ2=6.816,P=0.009),educational level(χ2=6.878,P=0.032),occupation(χ2=15.071,P=0.010),have the ability to prevent HIV(χ2=6.816,P=0.009),likely to be infected with HIV(χ2=11.420,P=0.001),have received condom(x2=4.097,P=0.043),the number of half-year same-sex partners(χ2=6.731,P=0.009),have heard of PrEP((χ2=21.744,P<0.001),have heard of post-exposure prophylaxis(χ2=15.329,P<0.001).Multivariate Logistic regression analysis of influencing factors of using PrEP daily include educational level(OR=3.636,95%CI=l.283～10.302),occupation(OR=2.118,95%CI=1.004～4.468),think it is difficult to prevent HIV(OR=0.553,95%CI=0.379～0.808),likely to be infected with HIV(OR=2.221,95%CI=1.408～3.503),the number of half-year same-sex partners(OR=0.672,95%CI=0.466～0.969),have heard of PrEP(OR=2.381,95%CI=1.604～3.536).Conclusion:The overall awareness rate of PrEP in MSM of Kunming City and Kaiyuan City of Honghe Prefecture in Yunnan Province is relatively high compared to similar studies in China,but the awareness rate in some MSM are low.Factors that affect awareness include ethnic,educational level,think it is difficult to prevent HIV,afraid of HIV,have heard of post-exposure prophylaxis and et al.MSM has a higher wiliness to use PrEP,factors that affect wiliness include educational level,occupation,think it is difficult to prevent HIV,likely to be infected with HIV,the number of half-year same-sex partners,awareness of PrEP.