Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Aug 24, 2024
Date Accepted: Nov 12, 2024
Cascade Services of HIV Pre-exposure Prophylaxis Among MSM with Sexually Transmitted Infections in Nineteen Cities across China：A Multicenter Cross-Sectional Survey
ABSTRACT
Background:
There is limited literature available regarding the acceptance of HIV pre-exposure prophylaxis (PrEP) cascade services among men who have sex with men with sexually transmitted infections (MSM-STIs).
Objective:
This study was to explore the HIV PrEP cascade services (knowledge, willingness, and use) among MSM-STIs, in order to promote the implementation of PrEP for Chinese MSM-STIs.
Methods:
A cross-sectional study was conducted using Respondent-Driven Sampling (RDS) method in nineteen cities from January to August 2022 in China. The study collected data on demographics, behaviors, and receipt of PrEP cascade services from participants who were not infected with HIV and who self-reported being infected with STIs. After using chi-square tests or Fisher's exact tests to analyze differences in receiving PrEP cascade services across different variables, multivariate logistic regression was employed to analyze the influences on PrEP cascade services.
Results:
A total of 1329 eligible participants were included in the study. Among them, 85.55% had heard of PrEP, 81.57% expressed their willingness to use PrEP if engaging in high-risk HIV behaviors, 70.58% had consulted a healthcare professional about HIV PrEP, 62.98% reported having used PrEP, and 46.35% possessed basic information about PrEP. The results of multivariate logistic regression model analysis showed that the same factors influenced both PrEP knowledge and willingness, including age, education, marital status, income, condom usage, participation in group sex, HIV status of the most recent male sexual partner, and PEP usage (P<0.05). The factors related to the PrEP use included income, engagement in commercial sex, participation in group sex, HIV status of the most recent male sexual partner, new drug usage and PEP usage (P<0.05).
Conclusions:
MSM-STIs received PrEP cascade services at a relatively high rate. MSM-STIs receiving PrEP services lacked understanding, underestimated HIV risk. Awareness lower than usage, suboptimal awareness could impede PrEP efficacy and lead to risk compensation. Clinical Trial: None
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