Discrepancy between behavioral-indicated and perceived candidacy for HIV pre-exposure prophylaxis among men who have sex with men in Chengdu, China / 北京大学学报(医学版)

OBJECTIVE@#To explore the discrepancy between behavioral-indicated candidacy and perceived candidacy (behavioral-perceived gap) and its associated factors of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), so as to identify the focus population of PrEP interventions and to design and implement targeted interventions.@*METHODS@#We recruited a sample of 622 HIV-negative MSM who were regular clients of a community-based organization located in Chengdu, China, from November to December 2021. A cross-sectional questionnaire was used to collect the participants' information on social demographics, PrEP-related knowledge and cognitions, and risk behaviors. In this study, behaviorally eligible for PrEP was defined as performing at least one type of high-risk behavior in the past six months, including inconsistent condom use, sex with an HIV-positive partner, confirmed sexual transmitted infections (STI) diagnosis, substance use, and post-exposure prophylaxis (PEP) experience. Logistic regression models were fitted, and multivariate analyses were adjusted for social demographics.@*RESULTS@#Among the 622 eligible participants, 52.6% (327/622) were classified as behaviorally eligible for PrEP. Only 37.9% (124/327) of the participants perceived themselves as appropriate candidates for PrEP and 62.1% (203/207) had discrepancy between behavioral-indicated and perceived candidacy. 85.9% (281/327) had heard of PrEP, and 14.2% (40/281) accessed PrEP information through health care providers. Of the 327 participants eligible for behavior-indicated PrEP use, about half (47.1%) knew how to obtain PrEP medication and 33.0% had a professional PrEP counseling experience. The majority (93.3%) had no or few friends using PrEP. 54.1% scored eight or above in PrEP knowledge level. 66.7% reported having two or more sexual partners in the past six months. After adjusting for age and recruitment channel, we found six factors that were associated with perceived candidacy for PrEP, including PEP use [adjusted odds ratio (ORA)=2.20; 95% confidence interval (CI): 1.33-3.63], PrEP availability (ORA=1.69; 95%CI: 1.06-2.68), a greater number of PrEP-using friends (ORA=4.92; 95%CI: 1.77-13.65), PrEP know-ledge (ORA=2.21; 95%CI: 1.38-3.56), multiple sexual partnership (ORA=1.77; 95%CI: 1.07-2.94), and perceiving a higher risk of HIV infection (ORA=4.02; 95%CI: 1.73-9.32). Substance use during sex and PrEP information channel were not statistically associated with this beha-vioral-perceived gap.@*CONCLUSION@#We observed a high discrepancy between behavioral-indicated and perceived candidacy for PrEP among Chengdu MSM in China. Future PrEP implementation efforts should be made in skills training in assessing HIV infection risk, increasing PrEP knowledge, providing professional PrEP counselling, and fostering PrEP support environment.

Association between response to repeated negative HIV testing and risk sexual behaviors in men who have sex with men in Chengdu / 中华流行病学杂志

Objective: To investigate the association between the response to repeated negative HIV testing and the risk sexual behaviors in men who have sex with men (MSM) in Chengdu. Methods: A total of 610 MSM were recruited by convenience sampling method through Chengdu Tongle Health Consultation Service Centre from March to May 2022. Data were collected from the MSM through questionnaire survey, including the demographic characteristics, sexual behaviors in the past 6 months, the response to rerpeated negative HIV testing. Univariate and multivariate logistic regression models were conducted to analyze the association between the response to repeated negative HIV testing and risk sexual behavior. Results: A total of 579 (94.9%) participants participated in the questionnaire survey and 354 (61.1%) subjects were included in the study.For the negative HIV testing, some MSM believed that they had taken effective protection measures (17.03±2.20), some believed that they were lucky (7.50±1.87) and some believed that they were at low risk (8.87±3.62). Multivariate logistic regression model showed that protected sexual behavior was negatively associated with group sex (aOR=0.80, 95%CI: 0.67-0.95), lucky was positively associated with casual sex (aOR=1.20, 95%CI: 1.06-1.35), inconsistent condom use (aOR=1.21, 95%CI: 1.06-1.37), group sex (aOR=1.26, 95%CI: 1.00-1.60), and multiple sexual partners (aOR=1.24, 95%CI: 1.09-1.42) and low risk perception was positively associated with multiple sexual partners only (aOR=1.08, 95%CI: 1.01-1.15). Conclusions: There were high levels of recognition of protected sexual behavior and lucky dimensions in response to repeated negative HIV testing and well risk perception in MSM in Chengdu. In HIV testing and counseling services, intervention and risk warning should be strengthened in MSM who believed that they are lucky to improve their awareness of safe sex and reduce the negative effects of fluke mind.

A survey on respiratory infectious diseases related health literacy and health behavior in Fengtai district, Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aims to survey respiratory infectious disease related health literacy (RIDHL) and health behavior (RIDHB) among residents in Fengtai district, Beijing, analyze impact factors of RIDHL , explore the association between RIDHL and RIDHB.</p><p><b>METHODS</b>Multistage sampling was employed and 1100 respondents were surveyed by self-designed questionnaires, which including social-demographic characteristics and evaluation of RIDHL and RIDHB. The survey results were described, the impact factors of RIDHL and the association between RIDHL and RIDHB were analyzed by analysis of variance or covariance.</p><p><b>RESULTS</b>A total of 998 qualified questionnaires were recollected with the effective rate of 90.7%. The respondents aged from 15 to 65, scored (71.3 +/- 19.0) points in RIDHL test. Of those respondents, 25.7% (256/998), 43.2% (432/998) and 31.1% (310/998) were evaluated as low( <60 points), medium (60 - 85 points), and high level ( > 85 points) of RIDHL, respectively. There were significant difference in RIDHL scores between registered and non-registered residents, who scored (74.1 +/- 18.9) and (68.4 +/- 18.8) points, respectively (P < 0.01). RIDHL sections were ranked as audiovisual (77.6%, 4647/5988), internet using (75.2%, 2251/2994), reading (74.6%, 3724/4990), map using (68.3%, 4090/5988) and quantitative (65.5%, 5230/7984) according to the accurate rates from high to low. Analysis of variance or covariance showed that RIDHL scores were significantly different among respondents with different ages, nationalities, educational levels, occupations, and incomes (P < 0.01), yet no significant differences among those with different genders and marital status (P > 0.05). Respondents scored (69.7 +/- 15.5) points in RIDHB test. The RIDHB scores ((64.5 +/- 15.0), (70.4 +/- 15.6), (72.5 +/- 14.9) points, respectively) increased among residents with low, medium and high level of RIDHL (P < 0.01).</p><p><b>CONCLUSION</b>Residents in Fengtai district, Beijing possessed medium level of RIDHL. The non-registered residents showed lower RIDHL than registered residents. Ages, nationalities, educational levels, occupations, and incomes were impact factors of RIDHL. People with higher level of RIDHL also showed a higher level of RIDHB.</p>