Barriers and facilitators in Pre-exposure Prophylaxis (PrEP) use intention among Chinese homosexual men / 《全球健康杂志（英文）》

Background: Despite strengthened efforts on human immunodeficiency virus (HIV) prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China. Pre-exposure prophylaxis (PrEP), a highly effective HIV-prevention tool, has recently been included in China's Action Plan of HIV Prevention and Control. To promote future PrEP implementation, this study aims to identify the barriers and facilitators in PrEP use intention among MSM in China.Methods: In 2018, a cross-sectional survey was conducted among 300 MSM in Nanjing, Jiangsu Province. Questions on demographics, sexual behavior (including a seven-item high-risk behavior index), PrEP use intention, PrEP-related awareness and accessibility, and a seven-item public HIV stigma scale were included in the questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP use intention. Results: Overall, 44.67％ of the participants had more than two male sexual partners and 5.56％ had HIV-positive sexual partners. Only 57.00％ had heard of PrEP and only four (1.33％) participants had used PrEP. However, 75.34％ expressed the willingness to use oral PrEP if its efficacy was assured. The beliefs that "PrEP can prevent HIV if taken as prescribed" (adjusted odds ratio (AOR) = 4.84, P < 0.001) and "PrEP can be scaled up in the community" (AOR = 3.24, P < 0.001) were positively associated with oral PrEP use intention. Concerns of side effects were negatively associated with oral PrEP use intention (AOR = 0.32, P = 0.006). Further, 77.00％ of the participants would choose injectable or implanted PrEP instead of oral PrEP. One of the PrEP stigma items, "Not certain if doctors can prescribe PrEP if I go to the clinic" was positively associated with the intention to use injectable or implanted PrEP (AOR = 3.03). The items "Heard of PrEP" (AOR = 2.74) and "PrEP can prevent HIV if taken as prescribed" (AOR = 2.65) were also positively related to the intention to use injectable or implanted PrEP. The most common concerns regarding PrEP use were efficacy (44.67％) and side effects (38.67％). The most common reasons for using injectable and implanted PrEP were adherence (81.94％ and 77.86％, respectively) and privacy concerns (56.48％ and 55.00％, respectively). Affordable price and coverage by health insurance were the driving factors for PrEP use. Conclusion: Given the low level of awareness of PrEP-related information in China, it's necessary to provide interventions for high-risk individuals and communities, in order to increase their awareness and knowledge of PrEP. Furthermore, additional alternatives to HIV prevention, such as long-acting injectable or implanted PrEP, should be investigated to reduce the risk of HIV infection in at-risk MSM. Even if this programme could be approved by the National Medical Products Administration of China and implemented, a supportive social environment for MSM is essential during its implementing.

The healthy living master plan (HLMP): Singapore′s experience and enlightenment / 中华预防医学杂志

The unbalanced economic development, the lifestyle changes of the residents, the aging before getting rich and the burden of non-communicable chronic diseases in China have brought great pressure on China′s health system. However, the prevention and control mechanism of chronic diseases in China is far from mature, which restricts the development of the prevention and control of chronic diseases in China. Singapore′s new concept on chronic disease management and the the 3-level theoretical framework are good experience in the world and deserve to be learned by China. This article introduced the Healthy Living Master Plan in health promotion practice in Singapore, and made suggestions on construction of health management system to cope with the disease burden in China.

Historical evolution and chinese definition of global health / 中华预防医学杂志

Under the background of globalization, public health issues are becoming more and more complicated. In the international arena, global health has gradually replaced international health and "global public health" as one of the dominant terms in the field of public health. However, until now, there is no unified understanding and definition for the concept of global health domestically and internationally. In this article, various foreign experts 'views and domestic experts' opinions about the concept of global health are collected and solicited, in order to generalize appropriate Chinese definition of global health of China.