Analysis of pre-exposure prophylaxis awareness,willingness,uptake patterns,barriers and needs among MSM students and its influencing factors
Objective To explore the pre-exposure prophylaxis(PrEP)awareness,willingness,uptake patterns,barriers and needs among Chinese student men who have sex with men(MSM),so as to provide relevant evidence for targeted interventions with PrEP.Methods A proportional sampling method was used to conduct a cross-sectional survey of MSM aged 16 years and older re-siding in 21 provinces,municipalities,and autonomous regions in mainland China between October 20 and December 20,2021,to collect information on demographic and sexual behavioral characteristics,and 923 students of them were selected as the subjects of this study.Thie chi-square test and Fisher's test were used for univariate analysis,followed by multivariate Logistic regression to ana-lyze the influencing factors of PrEP awareness and uptake.Results According to the cascade analysis method,the awareness,willingness,uptake and adherence rates of PrEP among the student MSM were obtained as 88.95％,67.36％,13.20％and 45.21％,respectively.HIV testing more than once in the last 3 months,and all of them were aware of the HIV test results of their sexual partners,and those with high frequency of condom use had a higher rate of awareness(OR=2.32,1.79,1.69,P＜0.05).Willingness rates were higher for those from the pilot city,using substances,and HIV testing more than once in the last 3 months(OR=2.13,1.65,1.69,P＜0.05).Higher rates of uptake were found among those from high-risk and pilot areas,presence of com-mercial sex,substance use,and high literacy(OR=5.60,3.54,2.81,1.92,4.54,P＜0.05).Adherence rates were higher among those who used one pill per day or both(OR=12.77,13.26,P＜0.05).The barriers and needs faced by student MSM were primari-ly personal concerns about medication side effects,preventative effects,and confidence in sexual behavioral styles,and the high cost of medication and related service costs.Conclusions The student MSM population in China is characterized by high aware-ness,low willingness,low uptake,and low adherence to PrEP.Targeted interventions should be considered and tailored by the de-partments to facilitate PrEP promotion among student MSM.
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