目的 系统评价中国男男性行为(men who have sex with men,MSM)者HIV暴露后预防用药接受意愿的影响因素.方法 在PubMed、Web of Science、The Cochrane Library、EMbase、中国知网、维普、万方和CBM数据库中,检索2024年9月5日前MSM HIV暴露后预防用药接受意愿相关因素的研究,采用RevMan 5.3软件分别对纳入的影响因素进行meta分析.结果 共纳入26篇文献,调查人数31 600例,提取20个影响因素.Meta分析结果显示:年龄≤30岁(OR=1.65,95％CI:1.31～2.07)、月收入 5 000～10 000 元(OR=1.96,95％CI:1.51～2.55)、月收入＞10 000 元(OR=1.98,95％CI:1.03～3.80)、HIV 阳性性伴侣(OR=2.47,95％CI:1.21～5.05)、多个性伴侣(OR=2.51,95％CI:1.90～3.32)、网约性伴侣(OR=2.03,95％CI:1.55～2.65)、知晓 HIV 相关知识(OR=2.33,95％CI:1.81～3.00)、知晓暴露后预防(post-exposure prevention,PEP)相关知识(OR=2.17,95％CI:1.33～3.54)、咨询过 PEP(OR=26.09,95％CI:5.34～127.41)、使用性毒品(OR=2.01,95％CI:1.18～3.42)、使用安全套(OR=2.10,95％CI:1.66～2.66)、HIV 检测≥2 次/年(OR=2.33,95％CI:1.80～3.02)、性传播感染(OR=1.93,95％CI:1.52～2.45)、商业性行为(OR=3.21,95％CI:1.95～5.30)、同伴性教育(OR=1.60,95％CI:1.23～2.08)是MSM者HIV暴露后预防用药接受意愿的促进因素;同性恋(OR=0.34,95％CI:0.23～0.49)是其阻碍因素.结论 我国MSM者HIV暴露后预防用药接受意愿的影响因素较多且复杂,未来应加强对HIV和PEP相关知识的宣传和推广,降低MSM人群中HIV发病率.
Meta-analysis of factors influencing willingness to accept HIV post-expo-sure prophylaxis among Chinese men who have sex with men
Objective To systematically evaluate the factors influencing the willingness to accept HIV post-exposure prophylaxis(PEP)among men who have sex with men(MSM)in China.Methods Studies related to the willingness to accept HIV PEP among MSM published before September 5,2024,were searched in PubMed,Web of Science,The Cochrane Library,EM base,China National Knowledge Infrastructure(CNKI),Wan fang,VIP,and CBM databases.Meta-analysis of the included factors was con-ducted using Rev Man 5.3 software.Results A total of 26 studies were included,with 31 600 participants,and 20 influencing factors were extracted.The results of the meta-analysis indicated that factors promoting the willingness to accept HIV PEP in-cluded:age≤30 years(OR=1.65,95％CI:1.31-2.07),monthly income of 5 000-10 000 yuan(OR=1.96,95％CI:1.51-2.55),monthly income＞10 000 yuan(OR=1.98,95％CI:1.03-3.80),having an HIV-positive sexual partner(OR=2.47,95％CI:1.21-5.05),multiple sexual partners(OR=2.51,95％CI:1.90-3.32),online sexual partners(OR=2.03,95％CI:1.55-2.65),awareness of HIV-related knowledge(OR=2.33,95％CI:1.81-3.00),awareness of PEP-related knowledge(OR=2.17,95％CI:1.33-3.54),having consulted about PEP(OR=26.09,95％CI:5.34-127.41),use of recreational drugs(OR=2.01,95％CI:1.18-3.42),condom use(OR=2.10,95％CI:1.66-2.66),HIV testing at least twice a year(OR=2.33,95％CI:1.80-3.02),sexually transmitted infections(OR=1.93,95％CI:1.52-2.45),commercial sex work(OR=3.21,95％CI:1.95-5.30),and peer education(OR=1.60,95％CI:1.23-2.08).The fac-tor hindering willingness was identified as being gay(OR=0.34,95％CI:0.23-0.49).Conclusion The factors influencing the will-ingness to accept HIV PEP among MSM in China are various and complex.Future efforts should focus on enhancing the promo-tion and dissemination of knowledge related to HIV and PEP to reduce the incidence of HIV within the MSM population.
Men who have sex with menPost exposure prophylaxisInfluencing factorsChinaMeta-analysis
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NSTL
万方数据
