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Article(id=1240738484328124895, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240738480549065614, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202411510, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732464000000, receivedDateStr=2024-11-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773744706470, onlineDateStr=2026-03-17, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773744706470, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773744706470, creator=13701087609, updateTime=1773744706470, updator=13701087609, issue=Issue{id=1240738480549065614, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773744705569, creator=13701087609, updateTime=1773744787657, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240738824918192654, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240738480549065614, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240738824922386959, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240738480549065614, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1663, endPage=1668, ext={EN=ArticleExt(id=1240738484655280627, articleId=1240738484328124895, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Research on the factors influencing the disconnection between knowledge and action regarding PrEP among university students in Nanning, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the disconnection between knowledge and action regarding HIV Pre-Exposure Prophylaxis (Pr EP) among university students with multiple sexual partners in Nanning, Guangxi, and analyze its influencing factors.

Methods

A cross-sectional survey was conducted in Nanning from November 19 to December 4, 2023, recruiting young university students who had at least one sexual partner in the past six months to investigate their knowledge and usage behaviors related to Pr EP. Students with only one sexual partner were used as a control group. Multivariate logistic regression models were employed to analyze the influencing factors of the knowledge-action disconnection.

Results

A total of 5 630 university students with at least one sexual partner were surveyed, among which 4 494 (79.8%) had one partner, 572 (10.2%) had 2-3 partners, and 564 (10.0%) had four or more partners. The occurrence of knowledge-action disconnection among students with one sexual partner was 1 558 (34.7%), among those with 2-3 partners was 201 (35.1%), and among those with four or more partners was 144 (25.5%). The multivariate logistic regression results indicated that sexual orientation (gay or bisexual) (OR=1.436, 95%CI: 1.150-1.793), testing frequency of less than six months (OR=1.423, 95%CI: 1.198-1.691), and testing frequency of more than six months (OR=1.386, 95%CI: 1.113-1.725) were factors influencing the knowledge-action disconnection regarding PrEP.

Conclusion

There is a significant disconnection between knowledge and action regarding PrEP among university students in Nanning with multiple sexual partners. PrEP education should focus on gay individuals and HIV testing behaviors to enhance the willingness to use PrEP and promote its actual implementation, thereby reducing the occurrence of knowledge-action disconnection.

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目的

了解广西壮族自治区（简称广西）南宁市大学生多性伴的HIV暴露前预防（pre-exposure prophylaxis，PrEP）知行分离情况，分析其影响因素。

方法

于2023年11月19日—12月4日在南宁市开展横断面调查，在广西南宁市招募在6个月内至少有1个性伴的青年大学生，调查其PrEP相关知识及使用行为等，将有1名性伴的大学生作为对照组。采用多因素logistic回归模型分析知行分离的影响因素。

结果

调查了至少有1名性伴的大学生5 630人，其中4 494人（79.8%）有1个性伴，572人（10.2%）有2～3个性伴，564人（10.0%）有4个及以上性伴。1个性伴的学生发生PrEP知行分离有1 558人（34.7%），2～3个性伴的学生发生PrEP知行分离有201人（35.1%），4个及以上性伴的学生发生PrEP知行分离有144人（25.5%）。多因素logistic回归结果显示，性取向为同性恋或双性恋（OR=1.436, 95%CI: 1.150～1.793）、<6个月的检测频率（OR=1.423, 95%CI: 1.198～1.691）及>6个月的检测频率（OR=1.386, 95%CI: 1.113～1.725）等是PrEP知行分离的影响因素。

结论

有多名性伴的南宁大学生存在明显的PrEP知行分离现象，在开展PrEP教育时应重点关注同性恋、HIV检测行为等，提高PrEP使用意愿，促进其转化为实际行动以减少PrEP知行分离的发生。

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宁传艺，E-mail:；
岑平，E-mail:；宁传艺与岑平为共同通信作者
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=GhAT7wTKypTVZHzscPAbcg==, magXml=HDaZeXAfzf7SqB/VaM2Ftw==, pdfUrl=null, pdf=AQrq0TBzEi9dWD1G8kGVYg==, pdfFileSize=609571, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=lLDVllIbJmu94xA+KUUbAw==, mapNumber=null, authorCompany=null, fund=null, authors=

彭洪滨（1998—），男，硕士在读，研究方向：艾滋病流行病学

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彭洪滨（1998—），男，硕士在读，研究方向：艾滋病流行病学

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彭洪滨（1998—），男，硕士在读，研究方向：艾滋病流行病学

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BMC Public Health, 2024, 24(1): 1009., articleTitle=Significant insights from a National survey in China: PrEP awareness, willingness, uptake, and adherence among YMSM students, refAbstract=null), Reference(id=1241081881584791940, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, doi=null, pmid=null, pmcid=null, year=2024, volume=7, issue=9, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[21], rfOrder=28, authorNames=Kampamba M, Nelumbu NN, Hikaambo CN, journalName=Health Sci Rep, refType=null, unstructuredReference=Kampamba M, Nelumbu NN, Hikaambo CN, et al. Awareness and willingness to use pre-exposure prophylaxis among the university of Zambia students: A cross-sectional study[J]. Health Sci Rep, 2024, 7(9): e70060.(In Chinese), articleTitle=Awareness and willingness to use pre-exposure prophylaxis among the university of Zambia students: A cross-sectional study, refAbstract=null)], funds=[Fund(id=1241081876216082636, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, awardId=2023GXNSFFA026007, language=CN, fundingSource=广西自然科学基金杰出青年科学基金项目(2023GXNSFFA026007), fundOrder=null, country=null), Fund(id=1241081876346106071, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, awardId=2023GXNSFAA026287, language=CN, fundingSource=广西自然科学基金项目(2023GXNSFAA026287), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241081865038262944, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, xref=1., ext=[AuthorCompanyExt(id=1241081865046651553, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, companyId=1241081865038262944, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Nursing, Guangxi Medical University, Nanning, Guangxi 530021, China), AuthorCompanyExt(id=1241081865055040162, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, companyId=1241081865038262944, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.广西医科大学护理学院，广西 南宁 530021)]), AuthorCompany(id=1241081865172480684, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, xref=2., ext=[AuthorCompanyExt(id=1241081865180869293, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, companyId=1241081865172480684, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.中共南宁市委办公室)]), AuthorCompany(id=1241081865323475635, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, xref=3., ext=[AuthorCompanyExt(id=1241081865327669941, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, companyId=1241081865323475635, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.广西医科大学信息与管理学院)]), AuthorCompany(id=1241081865499636416, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, xref=4., ext=[AuthorCompanyExt(id=1241081865508025023, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, companyId=1241081865499636416, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.广西医科大学第二附属医院)]), AuthorCompany(id=1241081866988614344, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, xref=5., ext=[AuthorCompanyExt(id=1241081867001197259, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, companyId=1241081866988614344, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=5.南宁市疾病预防控制中心，广西 南宁 530023)]), AuthorCompany(id=1241081867147997910, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, xref=6., ext=[AuthorCompanyExt(id=1241081867156386519, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, companyId=1241081867147997910, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=6.广西艾滋病防治重点实验室，广西 南宁 530021)])], figs=[ArticleFig(id=1241081873967935633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, language=EN, label=Table 1, caption=

The disconn tion between cognition of knowledge and sexual behaviors in college students of different characteristics［ n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数（n=5 630）知行一致（n=3 727）知行分离（n=1 903）χ2值P值
年龄（岁）1.0790.583
≤192 221 (39.4)1 487 (67.0)734 (33.0)
20～222 794 (49.6)1 840 (65.9)954 (34.1)
>22615 (10.9)400 (65.0)215 (35.0)
性别10.838<0.001
男2 868 (50.9)1 957 (68.2)911 (31.8)
女2 762 (49.1)1 770 (64.1)992 (35.9)
民族2.8110.245
汉族3 146 (55.9)2 104 (66.9)1 042 (33.1)
壮族1 991 (35.4)1 290 (64.8)701 (35.2)
其他493 (8.8)333 (67.5)160 (32.5)
户口45.615<0.001
城镇1 464 (26.0)864 (59.0)600 (41.0)
农村4 166 (74.0)2 863 (68.7)1 303 (31.3)
每月生活费（元）17.939<0.001
≤1 0001 567 (27.8)1 098 (70.1)469 (29.9)
1 001～2 0003 611 (64.1)2 354 (65.2)1 257 (34.8)
>2 000452 (8.0)275 (60.8)177 (39.2)
学校类型0.8130.367
综合类2 273 (40.4)1 489 (65.5)784 (34.5)
其他3 357 (59.6)2 238 (66.7)1 119 (33.3)
性伴数（个）19.205<0.001
14 494 (79.8)2 936 (65.3)1 558 (34.7)
2～3572 (10.2)371 (64.9)201 (35.1)
≥4564 (10.0)420 (74.5)144 (25.5)
性取向13.612<0.001
异性恋5 128 (91.1)3 432 (66.9)1 696 (33.1)
同性恋/双性恋502 (8.9)295 (58.8)207 (41.2)
HIV检测频率30.123<0.001
未做过4 381 (77.8)2 981 (68.0)1 400 (32.0)
<6个月788 (14.0)473 (60.0)315 (40.0)
>6个月461 (8.2)273 (59.2)188 (40.8)
HIV知识知晓情况60.047<0.001
知晓5 375 (95.5)3 501 (65.1)1 874 (34.9)
不知晓255 (4.5)226 (88.6)29 (11.4)
是否愿意使用PrEP206.4100.000
是2 972 (52.8)2 222 (74.8)750 (25.2)
否/不确定2 658 (47.2)1 505 (56.6)1 153 (43.4)
可接受的PrEP价格范围（元）22.832<0.001
免费1 960 (34.8)1 363 (69.5)597 (30.5)
1～3002 685 (47.7)1 694 (63.1)991 (36.9)
>300985 (17.5)670 (68.0)315 (32.0)
是否知晓PEP630.432<0.001
知晓886 (15.7)262 (29.6)624 (70.4)
不知晓4 744 (84.3)3 465 (73.0)1 279 (27.0)
是否愿意使用PEP27.506<0.001
是1 547 (27.5)941 (60.8)606 (39.2)
否/不确定4 083 (72.5)2 786 (68.2)1 297 (31.8)
曾经是否使用过PEP8.6660.003
是100 (1.8)80 (80.0)20 (20.0)
否5 530 (98.2)3 647 (65.9)1 883 (34.1)
), ArticleFig(id=1241081874102153372, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, language=CN, label=表1, caption=

不同特征大学生知行分离情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数（n=5 630）知行一致（n=3 727）知行分离（n=1 903）χ2值P值
年龄（岁）1.0790.583
≤192 221 (39.4)1 487 (67.0)734 (33.0)
20～222 794 (49.6)1 840 (65.9)954 (34.1)
>22615 (10.9)400 (65.0)215 (35.0)
性别10.838<0.001
男2 868 (50.9)1 957 (68.2)911 (31.8)
女2 762 (49.1)1 770 (64.1)992 (35.9)
民族2.8110.245
汉族3 146 (55.9)2 104 (66.9)1 042 (33.1)
壮族1 991 (35.4)1 290 (64.8)701 (35.2)
其他493 (8.8)333 (67.5)160 (32.5)
户口45.615<0.001
城镇1 464 (26.0)864 (59.0)600 (41.0)
农村4 166 (74.0)2 863 (68.7)1 303 (31.3)
每月生活费（元）17.939<0.001
≤1 0001 567 (27.8)1 098 (70.1)469 (29.9)
1 001～2 0003 611 (64.1)2 354 (65.2)1 257 (34.8)
>2 000452 (8.0)275 (60.8)177 (39.2)
学校类型0.8130.367
综合类2 273 (40.4)1 489 (65.5)784 (34.5)
其他3 357 (59.6)2 238 (66.7)1 119 (33.3)
性伴数（个）19.205<0.001
14 494 (79.8)2 936 (65.3)1 558 (34.7)
2～3572 (10.2)371 (64.9)201 (35.1)
≥4564 (10.0)420 (74.5)144 (25.5)
性取向13.612<0.001
异性恋5 128 (91.1)3 432 (66.9)1 696 (33.1)
同性恋/双性恋502 (8.9)295 (58.8)207 (41.2)
HIV检测频率30.123<0.001
未做过4 381 (77.8)2 981 (68.0)1 400 (32.0)
<6个月788 (14.0)473 (60.0)315 (40.0)
>6个月461 (8.2)273 (59.2)188 (40.8)
HIV知识知晓情况60.047<0.001
知晓5 375 (95.5)3 501 (65.1)1 874 (34.9)
不知晓255 (4.5)226 (88.6)29 (11.4)
是否愿意使用PrEP206.4100.000
是2 972 (52.8)2 222 (74.8)750 (25.2)
否/不确定2 658 (47.2)1 505 (56.6)1 153 (43.4)
可接受的PrEP价格范围（元）22.832<0.001
免费1 960 (34.8)1 363 (69.5)597 (30.5)
1～3002 685 (47.7)1 694 (63.1)991 (36.9)
>300985 (17.5)670 (68.0)315 (32.0)
是否知晓PEP630.432<0.001
知晓886 (15.7)262 (29.6)624 (70.4)
不知晓4 744 (84.3)3 465 (73.0)1 279 (27.0)
是否愿意使用PEP27.506<0.001
是1 547 (27.5)941 (60.8)606 (39.2)
否/不确定4 083 (72.5)2 786 (68.2)1 297 (31.8)
曾经是否使用过PEP8.6660.003
是100 (1.8)80 (80.0)20 (20.0)
否5 530 (98.2)3 647 (65.9)1 883 (34.1)
), ArticleFig(id=1241081874223788196, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, language=EN, label=Table 2, caption=

Multi or analysis of the disconnection between cognition of knowledge and sexual behaviors among college students

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β Wald 值0R值 (95%CI)P值
性别
男1.00
女-0.0120.0630.0340.989 (0.874～1.119)0.855
户口
城镇1.00
农村-0.3290.07121.7380.070 (0.626～0.827)<0.001
每月生活费（元）
≤1 0001.00
1 001～2 0000.0730.0721.0371.076 (0.934～1.239)0.308
>20000.1860.1272.1531.204 (0.940～1.543)0.142
性伴数（个）
11.00
2～3-0.0590.1070.3070.943 (0.765～1.162)0.580
≥4-0.3020.1147.0430.739 (0.591～0.924)0.008
性取向
异性恋1.00
同性恋/双性恋0.3620.11310.1651.436 (1.150～1.793)0.001
HIV检测频率
未检测过1.00
<6个月0.3530.08816.0721.423 (1.198～1.691)<0.001
>6个月0.3260.1128.5391.386 (1.113～1.725)0.003
HIV知识知晓情况
知晓1.00
不知晓-1.2600.20936.4860.284 (0.188～0.427)<0.001
是否愿意使用PrEP
是1.00
否/不确定0.8420.065170.1212.322 (2.046～2.635)<0.001
可接受的PrEP价格范围（元）
免费1.00
1～3000.1830.0706.8191.201 (1.047～1.378)0.009
>300-0.0060.0930.0040.994 (0.829～1.192)0.947
是否知晓PEP
知晓1.00
不知晓-1.6970.084408.7800.183 (0.155～0.216)<0.001
是否愿意使用PEP
是1.00
否/不确定-0.4490.07139.4720.638 (0.555～0.734)<0.001
曾经是否使用过PEP
是1.00
否1.2500.27820.1783.490 (2.023～6.022)<0.001
), ArticleFig(id=1241081874345423022, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, language=CN, label=表2, caption=

大学生知行分离的多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β Wald 值0R值 (95%CI)P值
性别
男1.00
女-0.0120.0630.0340.989 (0.874～1.119)0.855
户口
城镇1.00
农村-0.3290.07121.7380.070 (0.626～0.827)<0.001
每月生活费（元）
≤1 0001.00
1 001～2 0000.0730.0721.0371.076 (0.934～1.239)0.308
>20000.1860.1272.1531.204 (0.940～1.543)0.142
性伴数（个）
11.00
2～3-0.0590.1070.3070.943 (0.765～1.162)0.580
≥4-0.3020.1147.0430.739 (0.591～0.924)0.008
性取向
异性恋1.00
同性恋/双性恋0.3620.11310.1651.436 (1.150～1.793)0.001
HIV检测频率
未检测过1.00
<6个月0.3530.08816.0721.423 (1.198～1.691)<0.001
>6个月0.3260.1128.5391.386 (1.113～1.725)0.003
HIV知识知晓情况
知晓1.00
不知晓-1.2600.20936.4860.284 (0.188～0.427)<0.001
是否愿意使用PrEP
是1.00
否/不确定0.8420.065170.1212.322 (2.046～2.635)<0.001
可接受的PrEP价格范围（元）
免费1.00
1～3000.1830.0706.8191.201 (1.047～1.378)0.009
>300-0.0060.0930.0040.994 (0.829～1.192)0.947
是否知晓PEP
知晓1.00
不知晓-1.6970.084408.7800.183 (0.155～0.216)<0.001
是否愿意使用PEP
是1.00
否/不确定-0.4490.07139.4720.638 (0.555～0.734)<0.001
曾经是否使用过PEP
是1.00
否1.2500.27820.1783.490 (2.023～6.022)<0.001
), ArticleFig(id=1241081874467057847, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, language=EN, label=Table 3, caption=

Subgroup analysis of the risk of disconnection between cognition of knowledge and sexual behaviors among college students with different numbers of sexual partners

, figureFileSmall=null, figureFileBig=null, tableContent=
变量性伴数（个）
1 (n=4 494)2～3 (n=572)≥4 (n=564)
性别
男1.001.001.00
女0.987 (0.862～1.130)0.895 (0.594～1.341)1.012 (0.624～1.626)
户口
城镇1.001.001.00
农村0.762 (0.652～0.890)0.504 (0.326～0.778)0.555 (0.334～0.923)
每月生活费（元）
≤1 0001.001.001.00
1 001～2 0001.009 (0.864～1.180)1.500 (0.942～2.418)1.520 (0.921～2.546)
>2 0001.319 (0.994～1.746)0.811 (0.387～1.669)1.098 (0.471～2.455)
性取向
异性恋1.001.001.00
同性恋/双性恋1.448 (1.063～1.966)1.943 (1.240～3.051)1.080 (0.622～1.842)
HIV检测频率
未检测过1.001.001.00
<6个月1.373 (1.129～1.667)1.292 (0.764～2.172)2.055 (1.167～3.586)
>6个月1.441 (1.126～1.839)1.202 (0.608～2.337)1.313 (0.554～2.966)
HIV知识知晓情况
知晓1.001.001.00
不知晓0.373 (0.233～0.572)0.040 (0.002～0.210)0.208 (0.047～0.639)
是否愿意使用PrEP
是1.001.001.00
否/不确定2.239 (1.947～2.576)2.344 (1.550～3.568)3.558 (2.269～5.639)
可接受的PrEP价格范围（元）
免费1.001.001.00
1～3001.191 (1.023～1.386)1.230 (0.788～1.929)1.071 (0.645～1.769)
>3000.967 (0.789～1.184)1.194 (0.670～2.119)1.118 (0.587～2.082)
是否知晓PEP
知晓1.001.001.00
不知晓0.188 (0.157～0.225)0.224 (0.131～0.375)0.092 (0.045～0.179)
是否愿意使用PEP
是1.001.001.00
否/不确定0.652 (0.558～0.762)0.613 (0.395～0.949)0.589 (0.358～0.977)
曾经是否使用过PEP
是1.001.001.00
否3.341 (1.780～6.655)3.687 (1.159～14.584)4.709 (0.905～37.281)
), ArticleFig(id=1241081875993784508, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240738484328124895, language=CN, label=表3, caption=

不同性伴数大学生知行分离风险的亚组分析[0R值(95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量性伴数（个）
1 (n=4 494)2～3 (n=572)≥4 (n=564)
性别
男1.001.001.00
女0.987 (0.862～1.130)0.895 (0.594～1.341)1.012 (0.624～1.626)
户口
城镇1.001.001.00
农村0.762 (0.652～0.890)0.504 (0.326～0.778)0.555 (0.334～0.923)
每月生活费（元）
≤1 0001.001.001.00
1 001～2 0001.009 (0.864～1.180)1.500 (0.942～2.418)1.520 (0.921～2.546)
>2 0001.319 (0.994～1.746)0.811 (0.387～1.669)1.098 (0.471～2.455)
性取向
异性恋1.001.001.00
同性恋/双性恋1.448 (1.063～1.966)1.943 (1.240～3.051)1.080 (0.622～1.842)
HIV检测频率
未检测过1.001.001.00
<6个月1.373 (1.129～1.667)1.292 (0.764～2.172)2.055 (1.167～3.586)
>6个月1.441 (1.126～1.839)1.202 (0.608～2.337)1.313 (0.554～2.966)
HIV知识知晓情况
知晓1.001.001.00
不知晓0.373 (0.233～0.572)0.040 (0.002～0.210)0.208 (0.047～0.639)
是否愿意使用PrEP
是1.001.001.00
否/不确定2.239 (1.947～2.576)2.344 (1.550～3.568)3.558 (2.269～5.639)
可接受的PrEP价格范围（元）
免费1.001.001.00
1～3001.191 (1.023～1.386)1.230 (0.788～1.929)1.071 (0.645～1.769)
>3000.967 (0.789～1.184)1.194 (0.670～2.119)1.118 (0.587～2.082)
是否知晓PEP
知晓1.001.001.00
不知晓0.188 (0.157～0.225)0.224 (0.131～0.375)0.092 (0.045～0.179)
是否愿意使用PEP
是1.001.001.00
否/不确定0.652 (0.558～0.762)0.613 (0.395～0.949)0.589 (0.358～0.977)
曾经是否使用过PEP
是1.001.001.00
否3.341 (1.780～6.655)3.687 (1.159～14.584)4.709 (0.905～37.281)
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南宁市大学生多性伴与PrEP知行分离的影响因素研究
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彭洪滨 1 , 张涌凯 2 , 赵越 3 , 罗霞 1 , 梁银霞 1, 4 , 李雨轩 1 , 李春燕 1 , 潘仙嫩 1 , 岑平 5 , 宁传艺 1, 6
现代预防医学 | 健康与社会行为 2025,52(9): 1663-1668
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现代预防医学 | 健康与社会行为 2025, 52(9): 1663-1668
南宁市大学生多性伴与PrEP知行分离的影响因素研究
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彭洪滨1, 张涌凯2, 赵越3, 罗霞1, 梁银霞1, 4, 李雨轩1, 李春燕1, 潘仙嫩1, 岑平5 , 宁传艺1, 6
作者信息
  • 1.广西医科大学护理学院，广西 南宁 530021
  • 2.中共南宁市委办公室
  • 3.广西医科大学信息与管理学院
  • 4.广西医科大学第二附属医院
  • 5.南宁市疾病预防控制中心，广西 南宁 530023
  • 6.广西艾滋病防治重点实验室，广西 南宁 530021

    • 彭洪滨（1998—），男，硕士在读，研究方向：艾滋病流行病学

通讯作者:

宁传艺，E-mail:；
岑平，E-mail:；宁传艺与岑平为共同通信作者
Research on the factors influencing the disconnection between knowledge and action regarding PrEP among university students in Nanning
Hong-bin PENG1, Yong-kai ZHANG2, Yue ZHAO3, Xia LUO1, Yin-xia LIANG1, 4, Yu-xuan LI1, Chun-yan LI1, Xian-nen PAN1, Ping CEN5 , Chuan-yi NING1, 6
Affiliations
  • School of Nursing, Guangxi Medical University, Nanning, Guangxi 530021, China
出版时间: 2025-05-10 doi: 10.20043/j.cnki.MPM.202411510
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摘要
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目的

了解广西壮族自治区（简称广西）南宁市大学生多性伴的HIV暴露前预防（pre-exposure prophylaxis，PrEP）知行分离情况，分析其影响因素。

方法

于2023年11月19日—12月4日在南宁市开展横断面调查，在广西南宁市招募在6个月内至少有1个性伴的青年大学生，调查其PrEP相关知识及使用行为等，将有1名性伴的大学生作为对照组。采用多因素logistic回归模型分析知行分离的影响因素。

结果

调查了至少有1名性伴的大学生5 630人，其中4 494人（79.8%）有1个性伴，572人（10.2%）有2～3个性伴，564人（10.0%）有4个及以上性伴。1个性伴的学生发生PrEP知行分离有1 558人（34.7%），2～3个性伴的学生发生PrEP知行分离有201人（35.1%），4个及以上性伴的学生发生PrEP知行分离有144人（25.5%）。多因素logistic回归结果显示，性取向为同性恋或双性恋（OR=1.436, 95%CI: 1.150～1.793）、<6个月的检测频率（OR=1.423, 95%CI: 1.198～1.691）及>6个月的检测频率（OR=1.386, 95%CI: 1.113～1.725）等是PrEP知行分离的影响因素。

结论

有多名性伴的南宁大学生存在明显的PrEP知行分离现象，在开展PrEP教育时应重点关注同性恋、HIV检测行为等，提高PrEP使用意愿，促进其转化为实际行动以减少PrEP知行分离的发生。

性伴  /  大学生  /  PrEP  /  知行分离  /  影响因素
Objective

To understand the disconnection between knowledge and action regarding HIV Pre-Exposure Prophylaxis (Pr EP) among university students with multiple sexual partners in Nanning, Guangxi, and analyze its influencing factors.

Methods

A cross-sectional survey was conducted in Nanning from November 19 to December 4, 2023, recruiting young university students who had at least one sexual partner in the past six months to investigate their knowledge and usage behaviors related to Pr EP. Students with only one sexual partner were used as a control group. Multivariate logistic regression models were employed to analyze the influencing factors of the knowledge-action disconnection.

Results

A total of 5 630 university students with at least one sexual partner were surveyed, among which 4 494 (79.8%) had one partner, 572 (10.2%) had 2-3 partners, and 564 (10.0%) had four or more partners. The occurrence of knowledge-action disconnection among students with one sexual partner was 1 558 (34.7%), among those with 2-3 partners was 201 (35.1%), and among those with four or more partners was 144 (25.5%). The multivariate logistic regression results indicated that sexual orientation (gay or bisexual) (OR=1.436, 95%CI: 1.150-1.793), testing frequency of less than six months (OR=1.423, 95%CI: 1.198-1.691), and testing frequency of more than six months (OR=1.386, 95%CI: 1.113-1.725) were factors influencing the knowledge-action disconnection regarding PrEP.

Conclusion

There is a significant disconnection between knowledge and action regarding PrEP among university students in Nanning with multiple sexual partners. PrEP education should focus on gay individuals and HIV testing behaviors to enhance the willingness to use PrEP and promote its actual implementation, thereby reducing the occurrence of knowledge-action disconnection.

Sexual partners  /  University students  /  PrEP  /  Knowledge-action disconnection  /  Influencing factors
彭洪滨, 张涌凯, 赵越, 罗霞, 梁银霞, 李雨轩, 李春燕, 潘仙嫩, 岑平, 宁传艺. 南宁市大学生多性伴与PrEP知行分离的影响因素研究. 现代预防医学, 2025 , 52 (9) : 1663 -1668 . DOI: 10.20043/j.cnki.MPM.202411510
Hong-bin PENG, Yong-kai ZHANG, Yue ZHAO, Xia LUO, Yin-xia LIANG, Yu-xuan LI, Chun-yan LI, Xian-nen PAN, Ping CEN, Chuan-yi NING. Research on the factors influencing the disconnection between knowledge and action regarding PrEP among university students in Nanning[J]. Modern Preventive Medicine, 2025 , 52 (9) : 1663 -1668 . DOI: 10.20043/j.cnki.MPM.202411510
正文
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根据联合国艾滋病规划署（The Joint United Nations Programme on HIV/AIDS, UNAIDS）2023年的数据显示，全球估计有190万15～24岁的青春期女孩和青年女性感染艾滋病，而同年龄段的男性感染艾滋病的人数估计为120万[1]。作为性活跃人群，青年学生是我国艾滋病防控工作的重点人群之一[2]。人类免疫缺陷病毒（HIV）暴露前预防（pre-exposure prophylaxis, PrEP）已被证明是有效的生物学预防手段，并在许多国家得到了广泛应用[3-4]。然而，在我国PrEP的推广仍较为缓慢[5]。国内现有研究主要集中于艾滋病高危人群对PrEP和HIV暴露后预防（post-exposure prophylaxis, PEP）的使用意愿及知识普及情况，而针对拥有多名性伴侣的大学生群体，对PrEP知行分离现象的研究相对较少。因此，本研究旨在探讨有多名性伴侣的大学生对PrEP的知行分离情况及其影响因素，为相关政策的制定和干预措施的优化提供依据。
1　对象与方法
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1.1　对象
纳入标准：（1）在校大学生；（2）最近6个月有1个及以上的同性或异性性伴；（3）能独立自主完成电子问卷；（4）同意参加本次调查。排除标准：（1）外国留学生；（2）有严重心理健康问题的学生。本研究经广西医科大学伦理委员会批准（编号：2023KY0262），问卷首页设置知情同意书，所有研究对象均已知晓。
1.2　方法
按照学校-学院-班级多阶段分层整群抽样方法，依托于南宁市疾病预防控制中心在2023年11月19日—12月4日组织开展的健康教育活动，共线上调查28所学校，112个学院，合计117 118人。线上调查问卷内容包括人口学信息（性别、学校类型、每月生活费等）、行为学特征（性取向、性行为、HIV检测频率等）、HIV PrEP和PEP知识与使用情况等。每个IP地址只能填写一份调查问卷。本研究将有1名性伴的大学生作为对照组。PrEP相关知识的5个问题包括：“您是否了解过/听说过HIV暴露前预防用药？”“您认为HIV暴露前预防用药的作用是？”“您认为谁应该使用HIV暴露前预防用药？”“您认为在使用HIV暴露前预防用药期间，发生性行为时是否需要使用安全套？”“您认为HIV暴露前预防用药的服用方法是？”，正确回答4题即为知晓。指标定义：已知晓PrEP且符合PrEP使用指征（包含青少年及青壮年在内的性活跃群体）[3]，但在发生性行为时未使用PrEP的情况，视为存在“知行分离”；在6个月中，有2名及以上的性伴侣定义为“多性伴”。
1.3　统计分析
用SPSS 27.0软件进行统计学分析。采用χ2检验比较两组学生的社会人口学特征、HIV知晓情况、性行为特征、PrEP使用意愿，PEP知晓情况、PEP使用意愿、PEP使用情况等方面的差异，检验水准α=0.05。并以是否存在知行分离为因变量，将单因素结果中P<0.1的变量纳入多因素logistic回归中，分析大学生出现PrEP知行分离的影响因素。
2　结果
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2.1　一般情况
拥有至少1名性伴的大学生有5 630人，其中1 903人（33.8%）存在PrEP知行分离现象。2 794人（49.6%）年龄区间在20～22岁，2 868人为男性（50.9%），3 146人（55.9%）为汉族，4 166人（74.0%）为农村户口，3 611人每月生活费在1 001～2 000元，3 357人（59.6%）所在学校为非综合型大学。见表1。
2.2　性伴特征及性取向
4 494人（79.8%）有1个性伴，572人（10.2%）有2～3个性伴，564人（10.0%）有4个及以上性伴。1个性伴的学生发生知行分离有1 558人（34.7%），2～3个性伴的学生发生知行分离有201人（35.1%），4个及以上性伴的学生发生知行分离有144人（25.5%）。5 128人（91.1%）性取向为异性恋，其中1 696人（33.1%）发生知行分离；502人（8.9%）性取向为同性恋或双性恋，其中207人（41.2%）发生知行分离。见表1。
2.3　 HIV检测及艾滋病相关防控知识等情况
5 128人（91.1%）性取向为异性恋，4 381人（77.8%）未检测过HIV，5 375人（95.5%）知晓HIV知识，2 972人（52.8%）愿意使用PrEP，2 685人（47.7%）可接受1～300的PrEP价格，4 744人（84.3%）不知晓PEP，4 083人（72.5%）不确定或不愿意使用PEP，100人（1.8%）曾经使用过PEP。见表1。
2.4　知行分离影响因素
以是否出现知行分离为因变量，将单因素分析中P<0.1的变量纳入多因素中，其中包括性别、户口、每月生活费、性伴数量、性取向、HIV检测频率、HIV知识知晓情况、PrEP使用意愿、可接受的PrEP价格、PEP知识知晓情况、PEP使用需求、是否使用过PEP。多因素logistic回归分析结果显示，性取向为同性恋或双性恋（OR=1.436,95%CI: 1.150～1.793）、<6个月的检测频率（OR=1.423, 95%CI: 1.198～1.691）及>6个月的检测频率（OR= 1.386, 95%CI: 1.113～1.725）、不愿意或不确定是否愿意使用PrEP（OR=2.322, 95%CI: 2.046～2.635）、可接受1～300元的PrEP价格（OR=1.201,95%CI: 1.047～1.378）、未使用过PEP（OR=3.490,95%CI: 2.023～6.022）出现知行分离的风险更高（P<0.05）；农村户口（OR= 0.070, 95%CI: 0.626～0.827）、拥有4个及以上的性伴（OR=0.739, 95%CI: 0.591～0.924）、不知晓HIV相关知识（OR=0.284, 95%CI:0.188～0.427）、不知晓PEP（OR=0.183, 95%CI: 0.155～0.216）及不愿意或不确定是否愿意使用PEP（OR=0.638, 95%CI: 0.555～0.734）出现知行分离的风险更低（P<0.05）。见表2。
在亚组分析中，当拥有一名性伴时，性取向为同性恋或双性恋（OR=1.448, 95%CI: 1.063～1.966）、<6个月的检测频率（OR=1.373, 95%CI: 1.129～1.667）、>6个月的检测频率（OR=1.441, 95%CI: 1.126～1.839）、不愿意或不确定是否愿意使用PrEP（OR= 2.239,95%CI: 1.947～2.576）、可接受1～300元的PrEP价格（OR=1.191, 95%CI: 1.023～1.386）及未使用过PEP（OR=3.341, 95%CI: 1.780～6.655）是知行分离的危险因素；当拥有2～3名性伴时，不愿意或不确定是否愿意使用PrEP（OR=2.344, 95%CI: 1.550～3.568）及未使用过PEP（OR=3.687, 95%CI: 1.159～14.584）是知行分离的危险因素；当拥有4名及以上的性伴时，<6个月的检测频率（OR=2.055, 95%CI: 1.167～3.586）及不愿意或不确定是否愿意使用PrEP（OR=3.558, 95%CI:2.269～5.639）是知行分离的危险因素。见表3。
3　讨论
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本次调查研究结果中，至少有1名性伴的大学生发生PrEP知行分离的比例为33.8%，低于男男性行为（men who have sex with men, MSM）者等群体[6-8]。大学生群体普遍接受较高水平教育，且高校定期举办针对性传播疾病和HIV预防的宣传活动，因此该群体对PrEP和相关健康知识的掌握程度较高。同时，大学生相较于其他群体对新事物的接受度更高，从而在一定程度上减少知行分离的情况。但该人群仍存在较为明显的知行分离现象，这可能与教育内容未能触及他们的信念和态度有关[9]。研究结果显示，在性伴数量较多（≥4）时，知行一致的比例显著上升。这一结果反映了性伴数量较多的大学生可能具备更高的风险认知和行为一致性。该类学生意识到自身有着更高的感染风险，因此更愿意采取PrEP等预防措施降低HIV感染的可能性。
本研究结果显示，有HIV检测行为较易发生知行分离，这可能由于在接受HIV检测后，尤其是结果为阴性时，可能会暂时降低对PrEP的重视，认为自己短期内没有感染的风险。同时，当HIV检测结果为阴性后，个体可能产生一种虚假的安全感，认为自己短期内没有感染的风险，导致他们对未来的风险评估下降，从而忽视PrEP作为持续预防措施的重要性，推迟或放弃使用PrEP[10]。高校等机构可向大学生普及HIV风险以及PrEP的重要性，强调PrEP的预防作用，减少检测后因阴性结果产生的虚假安全感而放弃使用PrEP。本研究结果也发现，性取向为同性恋或双性恋的大学生较易发生知行分离，这一发现与其他研究结果一致[11-12]，该类大学生，尤其是女性，由于担心社会污名化与歧视，往往对PrEP的使用保持谨慎态度，污名化与歧视带来的心理压力迫使他们选择其他预防措施或完全不采取预防措施，从而导致知行不一致的现象持续存在[13]。
本研究结果显示，HIV相关知识知晓较高出现知行分离现象的风险显著高于其余学生。这与既往的研究结论相似[14]，大学生虽然对HIV预防知识有一定的了解，但仍有不采取防护措施的可能性[15]，对于自身的行为与风险之间的关系未能形成足够的警惕性，进而产生了认知和行为的冲突[16]。这一现象反映了HIV知识可能不能有效改变人们的行为，高水平的HIV相关知识与使用PrEP等HIV预防行为之间没有显著的正相关[17]，这可能源于在大学所获得的PrEP相关知识仍然较为有限。对于大学生而言，相关健康教育仅涵盖了针对普通人群的基本内容，课程中缺乏关于性行为和使用PrEP进行防护的细节的深入教育。因此，应在基于学校的HIV教育中纳入更全面、具体和详细的相关知识。
本研究结果表明，不愿意或不确定是否愿意使用PrEP发生知行分离的风险较大。提示对PrEP的态度显著影响了个体的预防行为[18]。这一发现与贵阳市研究中MSM者PrEP使用意愿结果相似[19]，缺乏对PrEP使用的明确意愿和未曾使用过PrEP的大学生对PrEP等预防手段的认知和信任程度不足，担忧其有效性或副作用，从而在使用PrEP时产生犹豫，影响了他们将知识转化为实际预防行为的能力，导致他们在面临风险时不采取行动，增加了知行分离的风险。
研究结果也发现，不知晓PEP相关知识、不愿意或不确定是否愿意使用PEP及未使用过PEP的大学生，出现PrEP知行分离的风险较低。这一结果表明，在该类大学生群体中，对PEP和PrEP产生的影响及行为具有一致性[20]。缺乏对PEP的认知或未曾使用过PEP的大学生可能也缺乏对PrEP知识的掌握[21]，这种认知的局限性使得他们在面对预防决策时不会产生显著的认知与行为冲突，从而减少了知行分离的发生。因此，对于这部分大学生，尤其需要针对性地提升他们对PEP和PrEP的基础认知，通过教育干预增加他们对这些预防措施的信任感和接受度，使他们能够更好地应对自身的高风险行为。
综上所述，有多名性伴侣的大学生在PrEP的使用中存在较为明显的知行分离状况。与性取向为同性恋或双性恋、有检测行为、不愿意或不确定是否愿意使用PrEP、较低的PrEP价格及未使用过PEP有关，在教育过程中，针对各因素采取侧重点不同的措施改善其知行分离情况，帮助该类大学生更好地将知识转化为实际的预防行为，从而有效减少知行分离现象。
本研究存在一定的局限性：（1）本研究为横断面研究设计，无法精准确定变量间因果关系；（2）问卷信息收集来自南宁市大学生自报告，存在一定的报告偏倚及回忆偏倚。
基金
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  • 广西自然科学基金杰出青年科学基金项目(2023GXNSFFA026007)
  • 广西自然科学基金项目(2023GXNSFAA026287)
文献
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2025年第52卷第9期
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doi: 10.20043/j.cnki.MPM.202411510
  • 接收时间：2024-11-25
  • 首发时间：2026-03-17
  • 出版时间：2025-05-10
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  • 收稿日期：2024-11-25
基金
广西自然科学基金杰出青年科学基金项目(2023GXNSFFA026007)
广西自然科学基金项目(2023GXNSFAA026287)
作者信息
    1.广西医科大学护理学院，广西 南宁 530021
    2.中共南宁市委办公室
    3.广西医科大学信息与管理学院
    4.广西医科大学第二附属医院
    5.南宁市疾病预防控制中心，广西 南宁 530023
    6.广西艾滋病防治重点实验室，广西 南宁 530021

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宁传艺，E-mail:；
岑平，E-mail:；宁传艺与岑平为共同通信作者
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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