ABSTRACT
Objective To study the acceptability and associated factors of pre-exposure prophylaxis (PrEP) based on different sexual purpose among human immunodeficiency virus (HIV) male serodiscordant couples.Methods HIV-negative female spouses of HIV-positive male in Guigang,Guiping and Pingnan county in Guangxi Zhuang Autonomous Region were recruited by the existing epidemic database and the method of cluster random sampling.A face-to-face questionnaire survey was conducted during June 2013 to November 2016.Information including the general condition and acceptability of PrEP was surveyed.x2 test and Logistic regression were used to analyze the data.Results A total of 526 qualified questionnaires were collected.The intention rate of PrEP based on physiological sexual purpose was 66.9％ (352/526),the intention rate of PrEP based on fertility purpose was 93.3％ (491/526).The difference was statistically significant (x =139.48,P＜0.01).The reasons of refusal included worrying about its safety,effectiveness poor confidentiality and low self-assessment risk of infection.Logistic analysis showed that the associated factors of the intention rate of PrEP based on physiological sexual purpose included cognition of PrEP (OR=0.70,P=0.014),the number of lifetime partners (OR=0.55,P＜0.01),frequency of sexual behavior (OR=1.33,P=0.016),willingness of condom use (OR=0.16,P＜0.01),infection risk self-assessment (OR =0.22,P＜0.01),male viral load (OR=1.25,P=0.035),male CD4+ T lymphocyte count (OR=0.37,P＜0.01) and male usefulness of medication or not (OR=1.59,P＜0.01).The influencing factors of the intention rate of PrEP based on physiological sexual purpose included with or without children (OR =1.70,P＜0.01),cognition of PrEP (OR=0.72,P=0.026),willingness of using condom (OR=0.18,P＜0.01),infection risk self-assessment (OR=0.14,P＜0.01) and male CD4+ T lymphocyte count (OR=0.45,P＜0.01).Conclusions The acceptability of PrEP based on fertility purpose is significantly higher than that on the physiological purpose.It is more feasible to conducting clinical trials of PrEP in peri-conceptional period HIV serodiscordant couples.The main influencing factors include the uninfected individual behavior characteristics and infection features of HIV infected men,and have nothing to do with the general social demographic characteristics.
ABSTRACT
Objective@#To explore the psychological distress status of HIV-infected pregnant women and analyze the possible influencing factors.@*Methods@#A total of 483 HIV-infected pregnant women were enrolled for this study by a cluster random sampling method from Sept. 2014 to Apr. 2017. Participants completed questionnaires including Distress Thermometer (DT), Berger HIV Stigma Scale (BHSS), HIV/AIDS Stress Scale (SS-HIV), Social Support Rating Scale (SSRS) and general questionnaire.@*Results@#The detection rate of psychological distress was 68.1%, the detection rates of moderate, severe and extreme psychological pain were 49.7%, 17.6% and 0.8% respectively. The detection rate of continuing pregnancy (75.2%) was higher than the termination pregnancy (56.4%), the difference was statistically significant (χ2=18.44, P<0.01). There were significant differences in the detection rates between continuing pregnancies at different gestational ages (χ2=15.41, P<0.01), and the termination pregnancy varies little with pregnancy (χ2=0.03, P>0.05). The mean DT score was 4.85 ± 1.82. The score of continuing pregnancy (5.94 ± 1.73) was higher than the termination pregnancy (4.20 ±1.96), the difference was statistically significant (t=4.57, P<0.01). Logistic regression analysis showed that CD4+ T lymphocyte count, infection route, perceived discrimination, related stress and social support were the common influencing factors of all pregnant women, factors affecting continuing pregnancy also include high risk pregnancy and gestational age.@*Conclusions@#HIV-infected pregnant women have higher incidence of psychological distress. The influencing factors are mainly related to the infection characteristics, pregnancy characteristics, BHSS, SS-HIV and SSRS, and has nothing to do with the general social demographic characteristics. The DT can be used as a screening tool to quickly identify psychological distress of the group.