Adherence to on-demand and daily oral pre-exposure prophylaxis for HIV among men who have sex with men in China: a cross-sectional study.

IF 3 3区 医学 Q2 INFECTIOUS DISEASES
Xue Yang, Qizi Liu, Hui Xue, Guang Zhang, Houlin Tang
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引用次数: 0

Abstract

Background: Pre-exposure prophylaxis (PrEP) has been effective in reducing HIV transmission in men who have sex with men (MSM). The effectiveness of PrEP is closely related to adherence, whether taken daily or on-demand. In China, there are few studies on PrEP adherence in MSM.

Methods: An online survey was conducted on the Heer Health Platform from July 6 to August 30, 2022. Participants were recruited through private messages sent to users who had purchased PrEP on the platform. The primary outcome was the proportion of daily and on-demand PrEP usage. Secondary outcomes included the proportions of high and low adherence to daily and on-demand PrEP among MSM. Univariate analyses were performed using the chi-square test or fisher's exact test, followed by multivariate logistic regression to identify factors associated with PrEP adherence.

Results: Among 384 participants, comprising 321 (83.6%) on-demand and 63 (16.4%) daily PrEP users. High adherence was observed in all daily users (100%) versus 81.9% (263) of on-demand users. During their last on-demand PrEP cycle, 8.7% (28/321) did not take the third pill on time, with 60.7% (17/28) delayed by over 2 h. 10.6% (34/321) missed the fourth pill, with 76.5% (26/34) delayed exceeded 2 h. Primary reasons were forgetting and busy schedules. Multivariable logistic regression identified three independent predictors of high adherence among on-demand PrEP users, including regular follow-up during PrEP use, having an HIV-positive sexual partner not on antiretroviral therapy and PrEP consultation (P < 0.05). Besides, statistically significant differences were found in variables such as sexuality, regular follow-up while taking PrEP, the number of male sexual partners in the last six months, the HIV status of the most recent male sexual partner in the past six months, and perceived HIV infection risk between the high adherence groups of on-demand and daily PrEP (P < 0.05).

Conclusions: Government and health authorities should continue to increase awareness and promotion of PrEP and condoms use among MSM. Emphasizing the importance of non-missing dose resolutions and regular follow-up can help improve PrEP adherence among MSM.

中国男男性行为者坚持按需和每日口服暴露前艾滋病预防:一项横断面研究
背景:暴露前预防(PrEP)在减少男男性行为者(MSM)的艾滋病毒传播方面是有效的。PrEP的有效性与依从性密切相关,无论是每天服用还是按需服用。在中国,关于MSM人群PrEP依从性的研究很少。方法:于2022年7月6日至8月30日在海尔健康平台进行在线调查。参与者是通过向在该平台上购买PrEP的用户发送私人信息来招募的。主要结果是每日和按需使用PrEP的比例。次要结局包括MSM中每日和按需PrEP的高依从性和低依从性的比例。采用卡方检验或fisher精确检验进行单因素分析,然后进行多因素logistic回归,以确定与PrEP依从性相关的因素。结果:在384名参与者中,包括321名(83.6%)按需使用PrEP和63名(16.4%)每日使用PrEP。在所有日常使用者(100%)中观察到高依从性,而在按需使用者中观察到81.9%(263)。在最后一个按需PrEP周期中,8.7%(28/321)患者未按时服用第三片,其中60.7%(17/28)患者延迟2小时以上。10.6%(34/321)患者未按时服用第四片,76.5%(26/34)患者延迟2小时以上。多变量logistic回归确定了PrEP按需使用者高依从性的三个独立预测因素,包括PrEP使用期间的定期随访,有未接受抗逆转录病毒治疗的艾滋病毒阳性性伴侣和PrEP咨询(P结论:政府和卫生当局应继续提高MSM对PrEP和避孕套使用的认识和推广。强调不遗漏剂量决议和定期随访的重要性有助于改善男男性行为者的PrEP依从性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Infectious Diseases
BMC Infectious Diseases 医学-传染病学
CiteScore
6.50
自引率
0.00%
发文量
860
审稿时长
3.3 months
期刊介绍: BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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