目的 对中国男男性行为者(men who have sex with men，MSM)的暴露前预防(pre-exposure prophylaxis，PrEP)使用意愿率及影响因素进行系统评价。方法 检索中国知网、维普、万方、中国生物医学文献服务系统、PubMed、Web of Science、Cochrane Library、Embase，检索时限为建库至2023年9月6日，查找公开发表的关于中国MSM人群PrEP使用意愿及影响因素的研究。使用美国卫生保健质量和研究机构推荐的质量评价标准评价文献质量，使用RevMan 5。3软件及Stata 13。1软件处理数据，分析中国MSM人群的PrEP使用意愿率及影响因素。结果 共纳入24篇横断面研究，19个影响因素，样本量16499例。结果 显示中国MSM人群PrEP使用意愿率为 60。4％[95％置信区间(confidence interval，CI)(51。8％，68。9％)];知晓 PrEP[比值比(odds ratio，OR)=5。26，95％CI(1。33，20。82)]、听说过 PrEP[OR=1。84，95％CI(1。28，2。64)]、＜25 岁[OR=1。92，95％CI(1。34，2。77)]、职业为学生[OR=1。92，95％CI(1。17，3。16)]、月收入 1000～3000 元[OR=1。36，95％CI(1。12，1。65)]、检测过人类免疫缺陷病毒[OR=2。05，95％CI(1。53，2。74)]、性病史[OR=1。75，95％CI(1。27，2。40)]、线上寻找性伴[OR=1。38，95％CI(1。19，1。59)]、公开性取向[OR=1。90，95％CI(1。27，2。84)]、外地户籍[OR=1。66，95％CI(1。37，2。02)]、会建议朋友使用PrEP[OR=20。14，95％CI(2。59，156。91)]是PrEP使用意愿的促进因素，性取向为同性恋[OR=0。67，95％CI(0。52，0。85)]是PrEP使用意愿的阻碍因素。结论 中国MSM人群PrEP使用意愿率低，影响因素较多。在日后的艾滋病防控工作中，应通过加强PrEP的教育和宣传、提供一定程度的PrEP费用支持、加强校园内的健康教育、加强社区组织和支持网络等措施以促进MSM人群PrEP的使用意愿。
Meta-analysis of willingness to use pre-exposure prophylaxis and influencing factors among men who have sex with men in China
Objective To systematically review the willingness to use pre-exposure prophylaxis(PrEP)and its influencing factors among men who have sex with men(MSM)in China.Methods We conducted a comprehensive search on various databases,including China National Knowledge Infrastructure,VIP database,Wanfang data,China Biomedical Literature Service System,PubMed,Web of Science,Cochrane Library,and Embase,covering the period from database inception to September 6th,2023.We focused on studies that publicly reported data on the willingness to use PrEP and its influencing factors among MSM in China.The quality of included studies was assessed using the quality evaluation criteria recommended by the Agency for Healthcare Research and Quality.RevMan 5.3 software and Stata 13.1 software were used to perform meta-analysis for the willingness to use PrEP and its influencing factors among MSM in China.Results A total of 24 cross-sectional studies with 19 influencing factors and a sample size of 16499 participants were included in the review.The results revealed a PrEP usage intention rate of 60.4％[95％confidence interval(CI)(51.8％,68.9％)]among the MSM population in China.Factors such as awareness of PrEP[odds ratio(OR)=5.26,95％CI(1.33,20.82)],having heard of PrEP[OR=1.84,95％CI(1.28,2.64)],age＜25 years[OR=1.92,95％CI(1.34,2.77)],being a student[OR=1.92,95％CI(1.17,3.16)],monthly income of 1000-3 000 yuan[OR=1.36,95％CI(1.12,1.65)],history of human immunodeficiency virus(HIV)testing[OR=2.05,95％CI(1.53,2.74)],history of sexually transmitted infections[OR=1.75,95％CI(1.27,2.40)],seeking sexual partners online[OR=1.38,95％CI(1.19,1.59)],openness about sexual orientation[OR=1.90,95％CI(1.27,2.84)],having a non-local household registration[OR=1.66,95％CI(1.37,2.02)],and recommending PrEP to friends[OR=20.14,95％CI(2.59,156.91)]were identified as promoting factors for the willingness to use PrEP.Conversely,a homosexual orientation[OR=0.67,95％CI(0.52,0.85)]was identified as a barrier to the willingness to use PrEP.Conclusions Chinese MSM have a low intention to use PrEP,and there are many factors affecting the intention to use PrEP in MSM.In the future HIV prevention and control work,measures such as strengthening education and publicity of PrEP,providing a certain degree of support for PrEP costs,strengthening health education on campus,strengthening community organizations and support networks should be taken to promote the willingness of MSM to use PrEP.
Pre-exposure prophylaxismen who have sex with menwillingness to useinfluencing factormeta-analysis
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万方数据
