Investigation on the correlation factors of positive Streptococcus pneumoniae antibody and IgG antibody level of Streptococcus pneumoniae in the elderly over 60 years old in Shenzhen.

BACKGROUND: Pneumococcal Polysaccharide Vaccine (PPV-23), designed to protect against the most common serotype of Streptococcus pneumoniae, is intended to protect the elderly and other high-risk groups. However, the immunogenicity of all 23 pneumococcal polysaccharide vaccines in older adults has not been thoroughly studied. OBJECTIVE: The purpose of this study is to look into the factors that influence the effect of the pneumonia vaccine on the elderly over 60 years old in Shenzhen, as well as their IgG antibody level against Streptococcus pneumoniae. METHODS: To determine the immune effectiveness of pneumococcal vaccination in older adults over 60 years old, we used the 3rd generation enzyme-linked immunosorbent assay to detect the antibody level of older adults to all 23 pneumococcal polysaccharide vaccines following pneumococcal immunization. RESULTS: Vaccination, the number of physical examinations, pneumonia knowledge, and the pneumonia vaccination policy of the elderly in Shenzhen were all positively correlated with Streptococcus pneumoniae antibody positivity. The distribution of subtypes did not differ between elderly adults (over 65) and younger adults (under 65). The GMCs of IgG antibodies to PPS were significantly lower in males than in females for types 7f, 18c and 19a. At the same time, we found that people with chronic respiratory disease have lower type 9n than people without chronic respiratory disease. Other chronic diseases, such as hypertension and diabetes, had no difference in subtype distribution. CONCLUSION: There was a statistically significant difference in antibody positivity rates for older people with more frequent medical check-ups in Shenzhen, indicating that publicity is playing a role. The effects of age, gender, and chronic diseases on naturally acquired anti-PPS IgG differ.

Systematic engineering enables efficient biosynthesis of L-phenylalanine in E. coli from inexpensive aromatic precursors.

BACKGROUND: L-phenylalanine is an essential amino acid with various promising applications. The microbial pathway for L-phenylalanine synthesis from glucose in wild strains involves lengthy steps and stringent feedback regulation that limits the production yield. It is attractive to find other candidates, which could be used to establish a succinct and cost-effective pathway for L-phenylalanine production. Here, we developed an artificial bioconversion process to synthesize L-phenylalanine from inexpensive aromatic precursors (benzaldehyde or benzyl alcohol). In particular, this work opens the possibility of L-phenylalanine production from benzyl alcohol in a cofactor self-sufficient system without any addition of reductant. RESULTS: The engineered L-phenylalanine biosynthesis pathway comprises two modules: in the first module, aromatic precursors and glycine were converted into phenylpyruvate, the key precursor for L-phenylalanine. The highly active enzyme combination was natural threonine aldolase LtaEP.p and threonine dehydratase A8HB.t, which could produce phenylpyruvate in a titer of 4.3 g/L. Overexpression of gene ridA could further increase phenylpyruvate production by 16.3%, reaching up to 5 g/L. The second module catalyzed phenylpyruvate to L-phenylalanine, and the conversion rate of phenylpyruvate was up to 93% by co-expressing PheDH and FDHV120S. Then, the engineered E. coli containing these two modules could produce L-phenylalanine from benzaldehyde with a conversion rate of 69%. Finally, we expanded the aromatic precursors to produce L-phenylalanine from benzyl alcohol, and firstly constructed the cofactor self-sufficient biosynthetic pathway to synthesize L-phenylalanine without any additional reductant such as formate. CONCLUSION: Systematical bioconversion processes have been designed and constructed, which could provide a potential bio-based strategy for the production of high-value L-phenylalanine from low-cost starting materials aromatic precursors.

Engineering a Novel Acetyl-CoA Pathway for Efficient Biosynthesis of Acetyl-CoA-Derived Compounds.

Acetyl-CoA is an essential central metabolite in living organisms and a key precursor for various value-added products as well. However, the intracellular availability of acetyl-CoA limits the efficient production of these target products due to complex and strict regulation. Here, we proposed a new acetyl-CoA pathway, relying on two enzymes, threonine aldolase and acetaldehyde dehydrogenase (acetylating), which can convert one l-threonine into one acetyl-CoA, one glycine, and generate one NADH, without carbon loss. Introducing the acetyl-CoA pathway could increase the intracellular concentration of acetyl-CoA by 8.6-fold compared with the wild-type strain. To develop a cost-competitive and genetically stable acetyl-CoA platform strain, the new acetyl-CoA pathway, driven by the constitutive strong promoter, was integrated into the chromosome of Escherichia coli. We demonstrated the practical application of this new acetyl-CoA pathway by high titer production of ß-alanine, mevalonate, and N-acetylglucosamine. At the same time, this pathway achieved a high-yield production of glycine, a value-added commodity chemical for the synthesis of glyphosate and thiamphenicol. This work shows the potential of this new acetyl-CoA pathway for the industrial production of acetyl-CoA-derived compounds.

Engineering acetylation platform for the total biosynthesis of D-amino acids.

Optically pure D-amino acids are key chemicals with various applications. Although the production of specific D-amino acids has been achieved by chemical synthesis or with in vitro enzyme catalysts, it is challenging to convert a simple carbon source into D-amino acids with high efficiency. Here, we design an artificial metabolic pathway by engineering bacteria to heterologously express racemase and N-acetyltransferase to produce N-acetyl-D-amino acids from L-amino acids. This new platform allows the cytotoxicity of D-amino acids to be avoided. The universal potential of this acetylation protection strategy for effectively synthesizing optically pure D-amino acids is demonstrated by testing sixteen amino acid targets. Furthermore, we combine pathway optimization and metabolic engineering in Escherichia coli and achieve practically useful efficiency with four specific examples, including N-acetyl-D-valine, N-acetyl-D-serine, N-acetyl-D-phenylalanine and N-acetyl-D-phenylglycine, with titers reaching 5.65 g/L, 5.25 g/L, 8.025 g/L and 130 mg/L, respectively. This work opens up opportunities for synthesizing D-amino acids directly from simple carbon sources, avoiding costly and unsustainable conventional approaches.

Associations between COVID-19 Vaccination Status and Self-Reported SARS-CoV-2 Infection among 8538 Children Aged 3-17 Years during a Massive COVID-19 Outbreak after China Changed Its Zero-COVID-19 Policy: A Cross-Sectional Survey.

This study aimed to investigate the associations between COVID-19 vaccination status and self-reported SARS-CoV-2 infection among children and adolescents aged 3-17 years during a massive COVID-19 outbreak after China changed its zero COVID policy. A cross-sectional online survey was conducted between 1 and 9 March 2023. Participants were the parents of children studying in kindergartens, primary schools, or secondary schools in Shenzhen. Convenient sampling was used. All kindergartens, primary schools, and secondary schools in the Longhua District of Shenzhen invited the parents of children and adolescents attending the schools. Interested parents completed an online survey. Multivariate logistic regression was fitted. Among 8538 participants, 40.9% self-reported that their children had SARS-CoV-2 infection after 7 December 2022, where 92.9% of them received two doses of the COVID-19 vaccines, and 74.6% received their second dose for more than six months. In multivariate analysis, children who received their second dose of the COVID-19 vaccination for no more than three months had a lower SARS-CoV-2 infection rate compared to unvaccinated children (<1 month: AOR: 0.17, 95% CI: 0.07, 0.44; 1-3 months: AOR: 0.54, 95% CI: 0.41, 0.75). The duration of protection conferred by the primary COVID-19 vaccination series was relatively short among children. A booster dose should be considered for children.

Application of machine learning for risky sexual behavior interventions among factory workers in China.

Introduction: Assessing the likelihood of engaging in high-risk sexual behavior can assist in delivering tailored educational interventions. The objective of this study was to identify the most effective algorithm and assess high-risk sexual behaviors within the last six months through the utilization of machine-learning models. Methods: The survey conducted in the Longhua District CDC, Shenzhen, involved 2023 participants who were employees of 16 different factories. The data was collected through questionnaires administered between October 2019 and November 2019. We evaluated the model's overall predictive classification performance using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. All analyses were performed using the open-source Python version 3.9.12. Results: About a quarter of the factory workers had engaged in risky sexual behavior in the past 6 months. Most of them were Han Chinese (84.53%), hukou in foreign provinces (85.12%), or rural areas (83.19%), with junior high school education (55.37%), personal monthly income between RMB3,000 (US$417.54) and RMB4,999 (US$695.76; 64.71%), and were workers (80.67%). The random forest model (RF) outperformed all other models in assessing risky sexual behavior in the past 6 months and provided acceptable performance (accuracy 78%; sensitivity 11%; specificity 98%; PPV 63%; ROC 84%). Discussion: Machine learning has aided in evaluating risky sexual behavior within the last six months. Our assessment models can be integrated into government or public health departments to guide sexual health promotion and follow-up services.

Characteristics of genotype, drug resistance, and molecular transmission network among newly diagnosed HIV-1 infections in Shenzhen, China.

The HIV-1 pandemic has persisted for four decades, and poses a major challenge to global public health. Shenzhen, a city with large number of migrant populations in China, is suffering HIV-1 epidemic. It is necessary to continuously conduct the molecular surveillance among newly diagnosed HIV-1 patients in these migrant population. In this study, plasma samples of newly diagnosed and ART-naive HIV-1 infections were collected from Shenzhen city in China. The partial genes of HIV-1 gag and pol were amplified and sequenced for the analysis of genotype, drug resistance, and molecular transmission network. Ninety-one sequences of pol gene were obtained from newly diagnosed HIV-1 infections in Shenzhen, and seven HIV-1 subtypes were revealed in this investigation. Among them, the circulating recombinant form (CRF) 07_BC was the mostly frequent subtype (53.8%, 49/91), followed by CRF01_AE (20.9%, 19/91), CRF55_01B (9.9%, 9/91), unique recombinant forms (URFs) (8.8%, 8/91), B (3.3%, 3/91), CRF59_01B (2.2%, 2/91), and CRF08_BC (1.1%, 1/91). The overall prevalence of pretreatment drug resistance (PDR) was 23.1% (21/91), and 52.38% (11/21) of the PDR was specific for the nonnucleotide reverse transcriptase inhibitors (NNRTIs). Furthermore, a total of 3091 pol gene sequences were used to generate 19 molecular transmission clusters, and then one growing cluster, a new cluster, and a cluster with growth reactivation were identified. The result revealed that more sexual partner, CRF_07BC subtype, and seven amino acid deletions in gag p6 region might be the influencing factors associated with the high risk of transmission behavior. Compared with CRF01_AE subtype, CRF07_BC subtype strains were more likely to form clusters in molecular transmission network. This suggests that long-term surveillance of the HIV-1 molecular transmission should be a critical measure to achieve a precise intervention for controlling the spread of HIV-1 in China.

A novel strategy for L-arginine production in engineered Escherichia coli.

BACKGROUND: L-arginine is an important amino acid with applications in diverse industrial and pharmaceutical fields. N-acetylglutamate, synthesized from L-glutamate and acetyl-CoA, is a precursor of the L-arginine biosynthetic branch in microorganisms. The enzyme that produces N-acetylglutamate, N-acetylglutamate synthase, is allosterically inhibited by L-arginine. L-glutamate, as a central metabolite, provides carbon backbone for diverse biological compounds besides L-arginine. When glucose is the sole carbon source, the theoretical maximum carbon yield towards L-arginine is 96.7%, but the experimental highest yield was 51%. The gap of L-arginine yield indicates the regulation complexity of carbon flux and energy during the L-arginine biosynthesis. Besides endogenous biosynthesis, N-acetylglutamate, the key precursor of L-arginine, can be obtained by chemical acylation of L-glutamate with a high yield of 98%. To achieve high-yield production of L-arginine, we demonstrated a novel approach by directly feeding precursor N-acetylglutamate to engineered Escherichia coli. RESULTS: We reported a new approach for the high yield of L-arginine production in E. coli. Gene argA encoding N-acetylglutamate synthase was deleted to disable endogenous biosynthesis of N-acetylglutamate. The feasibility of external N-acetylglutamate towards L-arginine was verified via growth assay in argA- strain. To improve L-arginine production, astA encoding arginine N-succinyltransferase, speF encoding ornithine decarboxylase, speB encoding agmatinase, and argR encoding an arginine responsive repressor protein were disrupted. Based on overexpression of argDGI, argCBH operons, encoding enzymes of the L-arginine biosynthetic pathway, ~ 4 g/L L-arginine was produced in shake flask fermentation, resulting in a yield of 0.99 mol L-arginine/mol N-acetylglutamate. This strain was further engineered for the co-production of L-arginine and pyruvate by removing genes adhE, ldhA, poxB, pflB, and aceE, encoding enzymes involved in the conversion and degradation of pyruvate. The resulting strain was shown to produce 4 g/L L-arginine and 11.3 g/L pyruvate in shake flask fermentation. CONCLUSIONS: Here, we developed a novel approach to avoid the strict regulation of L-arginine on ArgA and overcome the metabolism complexity in the L-arginine biosynthesis pathway. We achieve a high yield of L-arginine production from N-acetylglutamate in E. coli. Co-production pyruvate and L-arginine was used as an example to increase the utilization of input carbon sources.

Relationships of work stress and interpersonal needs with industrial workers' mental health: a moderated mediation model.

OBJECTIVES: This study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support. METHOD: A cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms. RESULT: Both the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B = 0.035, p < .001, Work stress→ Defeat→ Depression: B = 0.034, p < .001; Work stress→ Anxiety: B = 0.038, p < .001, Work stress→ Defeat→ Anxiety: B = 0.045, p < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B = 0.010, p = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect. CONCLUSION: The mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.

Sexual risk behaviours among factory workers in Shenzhen, China: a cross-sectional study.

BACKGROUND: Factory workers are a key population for HIV transmission in China, as they often engage in sexual risk behaviours. This study aims to evaluate sexual risk behaviours and associated factors among factory workers in Shenzhen, China. METHODS: A cross-sectional study was conducted by using multi-stage stratified cluster random sampling. Full-time workers aged ≥18years were eligible to participate in the study. A self-administered questionnaire was used to collect information. Univariate and multivariable logistic regression were applied to assess factors associated with sexual risk behaviours. RESULTS: A total of 2029 factory workers were included. Mean age was 37.2 (±4.4)years; 48.5% were men. Two-thirds (64.9%) had had vaginal intercourse. Their sexual risk behaviours included condomless sex with casual partners in the last sex episode (23.6%), multiple sex partners (11.5%) and engaging in commercial sex (8.4%), in the past year. Having HIV/AIDS knowledge (adjusted odds ratio (AOR) 0.41, 95% confidence interval (CI) 0.24-0.70) and using a condom at sexual debut (AOR 0.08, 95% CI 0.05-0.13) were factors associated with condomless sex with casual partners in the last sex episode. Males (AOR 3.03, 95% CI 1.96-4.69 and AOR 2.19, 95% CI 1.33-3.60), local workers (AOR 2.11, 95% CI 1.01-4.42 and AOR 3.42, 95% CI 1.63-7.21), being single (AOR 2.04, 95% CI 1.39-3.01 and AOR 2.49, 95% CI 1.61-3.87), having sexual debut aged Conclusions : Sexual risk behaviours were prevalent despite most participants having basic HIV/AIDS knowledge. Future workplace-based prevention programs should target factory workers and there should be a focus on enhanced sexual education to reduce HIV transmission in China.

Low Behavioral Intention to Use Any Type of HIV Testing and HIV Self-Testing among Migrant Male Factory Workers Who Are at High Risk of HIV Infection in China: A Secondary Data Analysis.

This study investigated the prevalence of and factors associated with behavioral intention to take up any type of HIV testing and HIV self-testing (HIVST) in the next six months among male migrant workers, who were at high risk of HIV infection, in Shenzhen, China. This was a secondary data analysis. A total of 363 subjects who had sexual intercourse with non-regular female sex partners and/or female sex workers in the past six months were selected. Logistic regression models were fitted for data analysis. About 16.5% of participants reported having used HIV testing in their lifetime and 12.7% for HIVST. Among the participants, 25.6% and 23.7% intended to take up any type of HIV testing and HIVST in the next six months, respectively. Significant factors associated with the behavioral intention to take up HIV testing and HIVST included individual-level factors based of the Health Belief Model (e.g., perceived benefit, perceived cue to action, perceived self-efficacy) and interpersonal-level factors (e.g., frequency of exposure to health-related content or HIV and STI-related content on short video apps). This study provided practical implications for designing interventions to increase the uptake of HIV testing and HIVST among migrant workers.

Reliability and Validity of the Defeat Scale among Internal Migrant Workers in China: Decadence and Low Sense of Achievement.

INTRODUCTION: Internal migrant workers have a great chance to experience defeat due to their low social status and economic situation. It has been reported that defeat might play a prospective role in predicting depression and anxiety; however, defeat is rarely explored among internal migrant workers due to the lack of appropriate measurement scales. The defeat scale (DS) can measure the feeling of defeat, social hierarchy reduction, and loss in social struggle. But its reliability and validity among internal migrant workers have not been reported. This study aimed to verify the content validity and structural validity of the DS among internal migrant workers in China and to explore its correlations with anxiety and depression. METHODS: 1805 internal migrant workers (IMWs) were recruited by stratified multistage sampling from 16 factories in Shenzhen, China. The content validity index (CVI) was used to assess content validity. Cronbach's coefficient alpha of each factor and the total scale were calculated to assess the reliability of DS. The scree test was used to determine the number of factors. Convergent validity and discriminant validity were estimated by calculating the average variance extracted and composite reliability. Logistic regression was performed to explore the effects of DS scores on anxiety and depression. RESULTS: Mean score of DS among IMWs was 18.42 ± 9.40. There were 606 (33.6%) IMWs who were considered to have depression symptoms, and 524 (29.0%) IMWs were considered to have anxiety symptoms. A two-factor model was obtained and fitted well (CFI = 0.956, GFI = 0.932, IFI = 0.956, RMSEA = 0.068, SRMR = 0.052). Cronbach's alpha reliability coefficient for the DS was 0.92. Logistic regression showed that DS scores were positively associated with anxiety and depression among IMWs. CONCLUSIONS: DS performed well among IMWs on content validity and structural validity, and it was suitable as a measurement instrument to assess defeat among this population. Defeat was positively associated with anxiety and depression and might play an important role in the mental health of IMWs.

Changes in COVID-19 Vaccine Acceptability among Parents with Children Aged 6-35 Months in China-Repeated Cross-Sectional Surveys in 2020 and 2021.

China is considering to offer COVID-19 vaccination for children aged 6−35 months. This study investigated the changes in COVID-19 vaccine acceptability and associated factors among parents with children aged 6−35 months in 2020 and 2021. Two rounds of cross-sectional online surveys were conducted among adult factory workers in Shenzhen, China. A subset of 208 (first round) and 229 (second round) parents with at least one child aged 6−35 months was included in the study. Parental acceptability of COVID-19 vaccination increased significantly from 66.8% in the first round to 79.5% in the second round (p = 0.01). Positive attitudes, perceived subjective norm, and perceived behavioral control were associated with higher parental acceptability in both rounds of surveys (p values ranged from <0.001 to 0.003). A negative association of negative attitudes with parental acceptability was observed in the second round (p = 0.02). No significant associations of exposure to information related to COVID-19 vaccination on social media with parental acceptability was found in either round of survey. Expanding the existing COVID-19 vaccination programs to cover children aged 6−35 months is necessary in China. Future programs should focus on modifying perceptions among parents to promote COVID-19 vaccination for children in this age group.

The information-motivation-behavioral skills (IMB) model of antiretroviral therapy (ART) adherence among people living with HIV in Shanghai.

The Information-Motivation-Behavioral skills (IMB) model of antiretroviral therapy (ART) adherence was applied in people living with HIV/AIDS in Shanghai, China to understand how adherence-related information, motivation and behavioral skills would affect ART adherence. The LifeWindows Information-Motivation-Behavioral Skills ART Adherence Questionnaire (LW-IMB-AAQ) was translated into Chinese and used. The IMB model was then implemented by testing standardized path estimates with standard model fitness indices in the participants. 426 participants from 11 community centres in Putuo district of Shanghai were recruited, of which 95.3% reported a high level of adherence (>95% adherence). The fitness indices of the final adjusted model were χ2 = 6.110, df = 7, p = 0.527(>0.05), CFI = 1.000(>0.9) and RMSEA = 0.000 (<0.08). In the model, information, which was separated into two sections (the perceived effect of ART on health and knowledge about ART medication), had an indirect effect on the ART adherence through behavioral skills, while motivation did not have such an effect. Neither information nor motivation had a direct effect on ART adherence. In addition, motivation was related to the two sections of information. The feasibility of the IMB model of ART adherence is verified by its application to predictive of adherence-related behaviors among HIV+ patients in this study.

Multifaceted Determinants of Sexual Intercourse with Non-Regular Female Sex Partners and Female Sex Workers among Male Factory Workers in China-A Cross-Sectional Survey.

With a stratified multi-stage sampling approach, 1361 male factory workers in the Longhua district of the Shenzhen Municipality of China were selected to investigate the multifaceted determinants of sexual intercourse with non-regular female sex partners (NRP) and female sex workers (FSW) among them. The results showed that 24.5% and 21.2% of participants had sexual intercourse with NRP and FSW in the past 6 months, respectively. More specifically, at the individual level, perceived higher job stress and maladaptive coping styles were linked with a higher likelihood of having sexual intercourse with NRP and FSW (adjusted odds ratios [AOR] ranged from 1.06 to 1.17). At the interpersonal level, those who had higher exposure to information related to sexual intercourse with NRP or FSW were more likely to have sex with these female sex partners (AOR: 1.08 & 1.11). At the social structural level, perceived social norms supporting multiple sex partnerships were linked with a higher likelihood of having sexual intercourse with NRP and FSW (AOR: 1.10 & 1.11). No interaction effects were found between the variables at different levels. Providing pre-employment training to clarify roles and job duties, introducing adaptive coping strategies, and addressing misconceptions of social norms are useful strategies to reduce sexual intercourse with NRP or FSW.

Changes in Parents' COVID-19 Vaccine Hesitancy for Children Aged 3-17 Years before and after the Rollout of the National Childhood COVID-19 Vaccination Program in China: Repeated Cross-Sectional Surveys.

China started to implement COVID-19 vaccination programs for children in July 2021. This study investigated the changes in parents' COVID-19 vaccine hesitancy for children before and after the vaccination program rollout. Repeated cross-sectional online surveys among full-time adult factory workers were conducted in Shenzhen, China. This analysis was based on 844 (first round) and 1213 parents (second round) who had at least one child aged 3−17 years. The prevalence of vaccine hesitancy for children aged 3−11 years dropped from 25.9% (first round) to 17.4% (second round), while such a prevalence for children aged 12−17 years dropped from 26.0% (first round) to 3.5% (second round) (p < 0.001). Positive attitudes, a perceived subjective norm, and perceived behavioral control related to children's COVID-19 vaccination were associated with lower vaccine hesitancy in both rounds. In the second round and among parents with children aged 3−11 years, negative attitudes and exposure to information on SARS-CoV-2 infection after receiving a primary vaccine series were associated with higher vaccine hesitancy, while exposure to experiences shared by vaccine recipients and infectiousness of variants of concern were associated with lower vaccine hesitancy. Regular monitoring of vaccine hesitancy and its associated factors among parents should be conducted to guide health promotion.

Awareness and uptake of non-occupational post-exposure prophylaxis (nPEP) among gay, bisexual and other men who have sex with men in China: a cross-sectional study.

Non-occupational post-exposure prophylaxis (nPEP) is recommended to reduce the likelihood of HIV infection after potential exposure. However, little is known about this practice among Chinese gay, bisexual and other men who have sex with men (GBM). GBM were enrolled from both centers for disease prevention and control (CDCs) and community health centers in six cities in China. Multivariable logistics regression was used to assess factors associated with awareness of and willingness to use nPEP. A total of 516 eligible GBM were included, 67.2% of whom were aware of nPEP, 76.0% were willing to use nPEP, and 2.3% had ever used nPEP. GBM who had college or higher education, had disclosed sexual orientation, had increased number of male sex partners in the last 6 months, and had ever tested for HIV were more likely to be aware of nPEP. Willingness to use nPEP was significantly associated with college or higher education, STI history, gay app use, and awareness of nPEP prior to study. Uptake of nPEP is still low among MSM in China. Efforts are needed to improve awareness of and access to nPEP among GBM, especially those at higher risk of HIV infection.