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Article(id=1321170632432271953, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170430187130949, articleNumber=null, orderNo=null, doi=10.11847/zgggws1143678, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1701100800000, receivedDateStr=2023-11-28, revisedDate=1727280000000, revisedDateStr=2024-09-26, acceptedDate=1732118400000, acceptedDateStr=2024-11-21, onlineDate=1792921224934, onlineDateStr=2026-10-25, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921224934, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921224934, creator=13701087609, updateTime=1792921224934, updator=13701087609, issue=Issue{id=1321170430187130949, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='2', pageStart='129', pageEnd='256', issueExtLink='null', onlineDate='null', pubDate='1739116800000', pubDateStr='2025-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921176716, creator='13701087609', updateTime=1792921176716, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=229, endPage=233, ext={EN=ArticleExt(id=1321170632671347282, articleId=1321170632432271953, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Awareness and willingness to use post-exposure prophylaxis and influencing factors among men who have sex with men in Heilongjiang province: a cross-sectional survey, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To assess the awareness and willingness to use post-exposure prophylaxis (PEP) and influencing factors among men who have sex with men (MSM) in Heilongjiang province for further promotion and implementation of PEP programs among MSM.

Methods

Using snowball sampling, we recruited 404 MSM residing in Harbin city who were ≥18 years old, HIV negative, or unaware of their HIV status. Face-to-face interviews were conducted among the MSM from September to November 2021 to collect relevant information by taking a self-developed PEP questionnaire based on that used in the national sentinel surveillance program. Chi-squared tests, univariate and multivariate unconditional logistic regression analyses were used to analyze factors influencing MSM's willingness to accept PEP.

Results

Of the MSM surveyed with a median age of 36 years, 68.812% reported the willingness to use PEP. Univariate analysis revealed that marital status, education, personal monthly income, sexual orientation, primary venue for finding male partners, HIV knowledge, sexual role during anal intercourse, number of male sex partners in the least 6 months, frequency of condom use during anal sex with men in the least 6 months, number of HIV tests, PEP awareness, and the maximum acceptable price of PEP were significant factors associating with willingness to accept PEP (all P<0.050). Multivariate unconditional logistic regression analysis showed that education level (odds ratio [OR]=5.500, 95% confidence interval [95%CI]: 2.174–13.911), number of male sex partners (OR=21.708, 95%CI: 6.258–75.305), frequency of condom use during anal sex with men in the least 6 months (OR=9.301, 95%CI: 2.711–31.904), and number of HIV tests (OR=3.218, 95%CI: 1.500–6.904) were the main factors influencing willingness to use PEP.

Conclusions

The willingness to accept PEP is relatively high among MSM in Heilongjiang province, suggesting that PEP should be promoted among local MSM to reduce HIV infection.

, authors=Xue TONG, Jing MA, Hongmei YAN, Shan HUI, Lin WANG, authorsList=Xue TONG, Jing MA, Hongmei YAN, Shan HUI, Lin WANG, authorCompany=null, correspAuthors=Lin WANG, authorNote=null, correspAuthorsNote=
WANG Lin, E-mail:
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目的

对黑龙江省男男性行为者（MSM）HIV暴露后预防服务利用情况进行调查，了解该人群艾滋病暴露后预防服务（PEP）的接受意愿及影响因素，为进一步在全省推广暴露后预防工作和制定实施方案提供可靠数据支持。

方法

于2022年9—11月采用滚雪球法招募年龄≥18周岁、HIV阴性或自身不清楚HIV感染情况的MSM为调查对象，收集社会人口学特征、艾滋病知识知晓率及相关行为、PEP接受意愿及其可能的影响因素等。采用χ2检验对MSM的PEP影响因素进行单因素和多因素非条件logistic回归分析。

结果

共调查404人，68.812%的人在HIV暴露后愿意使用PEP服务。单因素分析发现，婚姻状况、文化程度、月收入、性取向、最主要寻找男伴的场所、HIV知识知晓、肛交时性角色、最近6个月同性性伴数量、最近6个月与同性肛交安全套使用频率、HIV检测次数、PEP知晓情况、可承担PEP最高价格对PEP接受意愿差异均有统计学意义（P<0.050）。多因素非条件logistic 回归分析显示，文化程度（OR=5.500，95%CI=2.174～13.911）、同性性伴数量（OR=21.708，95%CI=6.258～75.305）、最近6个月与同性肛交安全套使用频率（OR=9.301，95%CI=2.711～31.904）、HIV检测次数（OR=3.218，95%CI=1.500～6.904）为PEP服务的主要影响因素。

结论

黑龙江省男男性行为者对PEP服务接受意愿较高。PEP作为一项有效的药物干预措施应尽快在全省推广，促进MSM主动就医，减少HIV感染。

, authors=佟雪, 马静, 闫红梅, 惠珊, 王林*, *, authorsList=佟雪, 马静, 闫红梅, 惠珊, 王林, authorCompany=null, correspAuthors=王林, authorNote=

佟雪（1984—），硕士，研究方向：疾病预防控制

, correspAuthorsNote=
王林，E-mail：
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佟雪（1984—），硕士，研究方向：疾病预防控制

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(2011-03-01)[2023-01-01]. https://www.doc88.com/p-50876706488.html., articleTitle=null, refAbstract=null), Reference(id=1321170640284009092, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=8, rfOrder=7, authorNames=null, journalName=null, refType=null, unstructuredReference=吴雨霏, 李荣健, 沈智勇, 等. 广西104名艾滋病非职业暴露男男性行为者入组服阻断药前的调查[J]. 中国热带医学, 2020, 20(10): 933-938., articleTitle=null, refAbstract=null), Reference(id=1321170640367895173, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=9, rfOrder=8, authorNames=null, journalName=null, refType=null, unstructuredReference=李建卓, 朱艳文, 任庆莹, 等. 济南市男男性行为者艾滋病非职业暴露后预防的需求调查[J]. 中国艾滋病性病, 2020, 26(1): 51-53, 62., articleTitle=null, refAbstract=null), Reference(id=1321170640439198342, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=10, rfOrder=9, authorNames=null, journalName=null, refType=null, unstructuredReference=曾梓, 刘惠, 徐杰, 等. 广西344名MSM艾滋病非职业暴露后预防服务需求及其影响因素分析[J]. 中国艾滋病性病, 2017, 23(7): 620-624., articleTitle=null, refAbstract=null), Reference(id=1321170640527278727, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=11, rfOrder=10, authorNames=null, journalName=null, refType=null, unstructuredReference=Ehui E, Tanon A, Guié P, et al. Antiretroviral prophylaxis after non-occupational exposure to HIV in Abidjan (Cote d'Ivoire)[J]. Médecine et Maladies Infectieuses, 2010, 40(10): 574-581., articleTitle=null, refAbstract=null), Reference(id=1321170640602776200, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=12, rfOrder=11, authorNames=null, journalName=null, refType=null, unstructuredReference=Hou J H, Wu Y M, Xie L, et al. Post-exposure prophylaxis: an underutilized biomedical HIV prevention method among gay, bisexual and other men who have sex with men in China[J]. AIDS Care, 2020, 32(12): 1573-1580., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321170635179541078, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, xref=null, ext=[AuthorCompanyExt(id=1321170635187929687, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, companyId=1321170635179541078, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150030, China), AuthorCompanyExt(id=1321170635196318296, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, companyId=1321170635179541078, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=黑龙江省疾病预防控制中心，哈尔滨 150030)])], figs=[ArticleFig(id=1321170639067660920, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, language=EN, label=Tab.1, caption=

Number and proportion of individuals reporting willingness to accept PEP among 404 MSM in Heilongjiang province by age, marital status, years of local residence, education, ethnicity, personal monthly income, sexual orientation, main ways of seeking sexual partners, HIV knowledge, age at first homosexual behavior, role for anal sex, number of sexual partners in past six months, frequency of condom use for same-sex commercial/heterosexual behavior, position for anal sex, number of sexual partners in the past six months, condom use for same-sex anal sex in the past six months, frequency of condom use for same-sex commercial/heterosexual behavior, number of HIV detections, PEP awareness/acquisition channels, and maximum acceptable cost of PEP: univariate analysis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类调查人数愿意使用PEP单因素分析
人数构成比/%人数使用率/%χ2值P值
愿意使用PEP情况404100.00027868.812
年龄组/岁≤24327.9212268.7503.8120.283
25～<4525061.88117168.400
45～<6010926.9807972.477
≥60133.218646.154
婚姻状况未婚、离异或丧偶32581.86424575.38524.523<0.001
在婚或同居7218.1363345.833
本地居住时间/年≤221553.21814969.3020.0520.820
>218946.78212968.254
文化程度初中及以下4511.1393884.4445.7660.016
高中及以上35988.86124066.852
民族汉族39798.26727268.5140.443
少数民族71.733685.714
月收入/元<3 00011829.2089177.1195.3590.021
≥3 00028670.79218765.385
性取向同性恋27768.56423484.477104.359<0.001
异性恋或未确定317.6731548.387
双性恋9623.7622930.208
最主要找男性性伴的场所互联网/交友软件24460.39618977.45921.4660.001
其他16039.6048955.625
HIV知识知晓知晓35186.88127879.202134.594<0.001
不知晓5313.11900.000
首次同性性行为年龄/岁12～<18369.2312363.8891.0590.303
18～5335490.76925572.034
肛交时性角色116039.60412578.12510.9380.004
012831.6838264.063
0.511628.7137161.207
最近6个月同性性伴数量113033.9437759.2318.6440.003
≥225366.05718773.913
最近6个月与同性肛交安全套使用频率有时使用或不用19851.69714673.7374.4240.035
每次都用18548.30311863.784
同性商业性行为安全套使用频率有时使用或不用2674.2861765.3851.000
每次都用925.714666.667
异性性行为安全套使用频率有时使用或不用1157.895872.7271.000
每次都用842.105562.500
HIV检测次数13812.1411950.00010.6250.001
≥227587.85920775.273
PEP知晓知晓31477.72322471.3384.1900.041
不知晓9022.2775460.000
知晓PEP途径网络14546.17810572.4140.2100.900
医生7222.9305069.444
MSM社会组织9730.8926971.134
可承担PEP最高价格/元<1 0009222.77292100.000122.515<0.001
1 000～3 00014335.39611983.217
>3 00016941.8326739.645
), ArticleFig(id=1321170639155741306, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, language=CN, label=表1, caption=

MSM对PEP接受意愿的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类调查人数愿意使用PEP单因素分析
人数构成比/%人数使用率/%χ2值P值
愿意使用PEP情况404100.00027868.812
年龄组/岁≤24327.9212268.7503.8120.283
25～<4525061.88117168.400
45～<6010926.9807972.477
≥60133.218646.154
婚姻状况未婚、离异或丧偶32581.86424575.38524.523<0.001
在婚或同居7218.1363345.833
本地居住时间/年≤221553.21814969.3020.0520.820
>218946.78212968.254
文化程度初中及以下4511.1393884.4445.7660.016
高中及以上35988.86124066.852
民族汉族39798.26727268.5140.443
少数民族71.733685.714
月收入/元<3 00011829.2089177.1195.3590.021
≥3 00028670.79218765.385
性取向同性恋27768.56423484.477104.359<0.001
异性恋或未确定317.6731548.387
双性恋9623.7622930.208
最主要找男性性伴的场所互联网/交友软件24460.39618977.45921.4660.001
其他16039.6048955.625
HIV知识知晓知晓35186.88127879.202134.594<0.001
不知晓5313.11900.000
首次同性性行为年龄/岁12～<18369.2312363.8891.0590.303
18～5335490.76925572.034
肛交时性角色116039.60412578.12510.9380.004
012831.6838264.063
0.511628.7137161.207
最近6个月同性性伴数量113033.9437759.2318.6440.003
≥225366.05718773.913
最近6个月与同性肛交安全套使用频率有时使用或不用19851.69714673.7374.4240.035
每次都用18548.30311863.784
同性商业性行为安全套使用频率有时使用或不用2674.2861765.3851.000
每次都用925.714666.667
异性性行为安全套使用频率有时使用或不用1157.895872.7271.000
每次都用842.105562.500
HIV检测次数13812.1411950.00010.6250.001
≥227587.85920775.273
PEP知晓知晓31477.72322471.3384.1900.041
不知晓9022.2775460.000
知晓PEP途径网络14546.17810572.4140.2100.900
医生7222.9305069.444
MSM社会组织9730.8926971.134
可承担PEP最高价格/元<1 0009222.77292100.000122.515<0.001
1 000～3 00014335.39611983.217
>3 00016941.8326739.645
), ArticleFig(id=1321170639264793211, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, language=EN, label=Tab.2, caption=

Associations of education, number of sexual partners/condom use in homosexual anal sex in the past six months, and number of HIV detections with willingness to accept PEP among MSM in Heilongjiang province: multivariate logistic analysis

, figureFileSmall=null, figureFileBig=null, tableContent=
因素比较组对照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
文化程度初中及以下高中及以上1.1690.3899.0090.0035.5002.174～13.911
最近6个月同性性伴数量≥212.2300.62912.575<0.00121.7086.258～75.305
最近6个月与同性肛交安全套使用频率有时使用或不用每次都用1.7050.47312.962<0.0019.3012.711～31.904
HIV检测次数≥213.0780.63523.518<0.0013.2181.500～6.904
), ArticleFig(id=1321170639478702716, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170632432271953, language=CN, label=表2, caption=

MSM对PEP接受意愿的logistic多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素比较组对照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
文化程度初中及以下高中及以上1.1690.3899.0090.0035.5002.174～13.911
最近6个月同性性伴数量≥212.2300.62912.575<0.00121.7086.258～75.305
最近6个月与同性肛交安全套使用频率有时使用或不用每次都用1.7050.47312.962<0.0019.3012.711～31.904
HIV检测次数≥213.0780.63523.518<0.0013.2181.500～6.904
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黑龙江省男男性行为者HIV暴露后预防使用情况及影响因素分析
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佟雪 , 马静 , 闫红梅 , 惠珊 , 王林 *, *
中国公共卫生 | 调查报告与分析 2025,41(2): 229-233
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中国公共卫生 |调查报告与分析 2025 , 41 (2) : 229 -233
黑龙江省男男性行为者HIV暴露后预防使用情况及影响因素分析
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佟雪, 马静, 闫红梅, 惠珊, 王林*, *
作者信息
  • 黑龙江省疾病预防控制中心，哈尔滨 150030
通讯作者:
王林，E-mail：
作者简介:

佟雪（1984—），硕士，研究方向：疾病预防控制

Awareness and willingness to use post-exposure prophylaxis and influencing factors among men who have sex with men in Heilongjiang province: a cross-sectional survey
Xue TONG, Jing MA, Hongmei YAN, Shan HUI, Lin WANG
Affiliations
  • Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150030, China
    • Corresponding Author:
    WANG Lin, E-mail:
出版时间: 2025-02-10 doi: 10.11847/zgggws1143678
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摘要
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目的

对黑龙江省男男性行为者（MSM）HIV暴露后预防服务利用情况进行调查，了解该人群艾滋病暴露后预防服务（PEP）的接受意愿及影响因素，为进一步在全省推广暴露后预防工作和制定实施方案提供可靠数据支持。

方法

于2022年9—11月采用滚雪球法招募年龄≥18周岁、HIV阴性或自身不清楚HIV感染情况的MSM为调查对象，收集社会人口学特征、艾滋病知识知晓率及相关行为、PEP接受意愿及其可能的影响因素等。采用χ2检验对MSM的PEP影响因素进行单因素和多因素非条件logistic回归分析。

结果

共调查404人，68.812%的人在HIV暴露后愿意使用PEP服务。单因素分析发现，婚姻状况、文化程度、月收入、性取向、最主要寻找男伴的场所、HIV知识知晓、肛交时性角色、最近6个月同性性伴数量、最近6个月与同性肛交安全套使用频率、HIV检测次数、PEP知晓情况、可承担PEP最高价格对PEP接受意愿差异均有统计学意义（P<0.050）。多因素非条件logistic 回归分析显示，文化程度（OR=5.500，95%CI=2.174～13.911）、同性性伴数量（OR=21.708，95%CI=6.258～75.305）、最近6个月与同性肛交安全套使用频率（OR=9.301，95%CI=2.711～31.904）、HIV检测次数（OR=3.218，95%CI=1.500～6.904）为PEP服务的主要影响因素。

结论

黑龙江省男男性行为者对PEP服务接受意愿较高。PEP作为一项有效的药物干预措施应尽快在全省推广，促进MSM主动就医，减少HIV感染。

男男性行为者（MSM）  /  暴露后预防  /  黑龙江省
Objective

To assess the awareness and willingness to use post-exposure prophylaxis (PEP) and influencing factors among men who have sex with men (MSM) in Heilongjiang province for further promotion and implementation of PEP programs among MSM.

Methods

Using snowball sampling, we recruited 404 MSM residing in Harbin city who were ≥18 years old, HIV negative, or unaware of their HIV status. Face-to-face interviews were conducted among the MSM from September to November 2021 to collect relevant information by taking a self-developed PEP questionnaire based on that used in the national sentinel surveillance program. Chi-squared tests, univariate and multivariate unconditional logistic regression analyses were used to analyze factors influencing MSM's willingness to accept PEP.

Results

Of the MSM surveyed with a median age of 36 years, 68.812% reported the willingness to use PEP. Univariate analysis revealed that marital status, education, personal monthly income, sexual orientation, primary venue for finding male partners, HIV knowledge, sexual role during anal intercourse, number of male sex partners in the least 6 months, frequency of condom use during anal sex with men in the least 6 months, number of HIV tests, PEP awareness, and the maximum acceptable price of PEP were significant factors associating with willingness to accept PEP (all P<0.050). Multivariate unconditional logistic regression analysis showed that education level (odds ratio [OR]=5.500, 95% confidence interval [95%CI]: 2.174–13.911), number of male sex partners (OR=21.708, 95%CI: 6.258–75.305), frequency of condom use during anal sex with men in the least 6 months (OR=9.301, 95%CI: 2.711–31.904), and number of HIV tests (OR=3.218, 95%CI: 1.500–6.904) were the main factors influencing willingness to use PEP.

Conclusions

The willingness to accept PEP is relatively high among MSM in Heilongjiang province, suggesting that PEP should be promoted among local MSM to reduce HIV infection.

men who have sex with men (MSM)  /  post-exposure prophylaxis  /  Heilongjiang province
佟雪, 马静, 闫红梅, 惠珊, 王林. 黑龙江省男男性行为者HIV暴露后预防使用情况及影响因素分析. 中国公共卫生, 2025 , 41 (2) : 229 -233 . DOI: 10.11847/zgggws1143678
Xue TONG, Jing MA, Hongmei YAN, Shan HUI, Lin WANG. Awareness and willingness to use post-exposure prophylaxis and influencing factors among men who have sex with men in Heilongjiang province: a cross-sectional survey[J]. Chinese Journal of Public Health, 2025 , 41 (2) : 229 -233 . DOI: 10.11847/zgggws1143678
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艾滋病目前仍是一种无有效治疗药物和疫苗的慢性传染病而成为全球重要的公共卫生问题。男男性行为（men who have sex with men，MSM）人群发生艾滋病相关高危行为频率较高，其艾滋病新发感染率明显高于其他人群[1]。近年来全国和黑龙江省HIV传播途径均以性传播为主，基于目前的行为学干预手段效果并不明显。在以往传统行为学干预手段基础上，药物阻断成了预防HIV感染的有效措施。HIV阻断药是指暴露后预防用药，基本原理是在暴露早期阶段，HIV 尚处于相对局限的区域内及时服用抗病毒药物以限制病毒的复制增殖，从而防止发生全身性感染。暴露后预防（post-exposure prophylaxis，PEP）最初用在医务人员、公安干警等发生的HIV职业暴露，之后逐步应用于因无保护性行为、不安全注射和被性侵等HIV 非职业暴露后预防（non-occupational post-exposure prophylaxis，nPEP）。美国、英国、加拿大、法国、澳大利亚等国家相继开展了PEP研究[2–3]，出台了本国的HIV非职业暴露预防用药指南，建议高危性行为暴露后有HIV感染风险的人在HIV暴露72 h之内，应及早开始按疗程服用抗转录病毒药物，已取得较好效果[4–6]。虽然 HIV职业暴露后预防在我国职业人群中已应用多年，但PEP服务尚未大范围开展。黑龙江省近年来MSM人群艾滋病感染率持续增高，且自2012年以来每年新报告病例中有约70%为同性传播。本文旨在分析黑龙江省MSM人群的PEP接受意愿及其影响因素，为后续在全省全面推广暴露后预防工作及制定黑龙江省PEP工作实施方案提供科学依据。
1　对象与方法
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1.1　对象
年满18周岁、HIV阴性或不清楚HIV感染情况的MSM，调查前一年内与男性同性发生过插入性口交或肛交性行为。调查开始前与研究对象均签署了知情同意书。本研究获得了黑龙江省疾病预防控制中心（下简称黑龙江省疾控中心）伦理委员会的批准（批号：黑CDC2021–03）。
1.2　方法
2022年9—11月在黑龙江省采用滚雪球法招募调查对象，选择12名不同特征及行为习惯的MSM作为“种子”，从而减少选择偏倚。调查对象纳入标准为：年龄≥18周岁、HIV阴性或自身不清楚HIV感染情况的MSM。采用结合国家哨点监测问卷自行设计的PEP专题调查问卷（中国疾控中心、黑龙江省疾控中心、哈尔滨市疾控中心专家指导下设计并修订），经过培训的固定社会组织调查员，在社会组织自愿咨询检测办公室，剔除重复之后进行一对一调查，收集社会人口学特征、艾滋病知识知晓及相关高危行为、PEP服务接受意愿及其可能影响因素信息，现场复核问卷，发现遗漏及逻辑错误现场补调。样本量计算：N=（Z2×pq/d2（p为预期的率，q=1–p，d为容许误差，N为样本量，Z为统计量），设定：p=50%，d=5%，Z=95%，计算N=385人，实际调查404人。艾滋病知识知晓定义为艾滋病8个单项知识中6项以上回答正确[7]。
1.3　统计学分析
Epi Data 3.1 建立数据库，双人录入核对无误；SPSS 25.0统计分析。计量资料不符合正态分布以M（P25，P75）表示，计数资料采用频数及构成比描述。采用χ2检验进行影响MSM接受PEP的单因素分析，筛选P<0.100变量纳入二元logistic回归方程作为自变量进行多因素分析（α=0.050），以PEP服务接受意愿情况为因变量。
2　结　果
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2.1　基本情况（表1）
共调查404人，年龄18～73岁，中位数36岁（31，46）；未婚、离异或丧偶占81.864%，在婚或同居占18.136%；本地居住≤2年占53.218%；高中及以上文化程度占88.861%；汉族占98.267%；月收入≥3 000元占70.792%；自我认同为同性恋占68.564%；互联网/交友软件寻找男性性伴占60.396%。艾滋病知识知晓率86.881%（351/404）。首次与同性发生肛交性行为年龄12～53岁，中位数23岁（20，25）；肛交时性角色为1（39.604%），0（31.683%），0.5（28.713%）。最近6个月，94.802%（383/404）与同性有肛交性行为，肛交性行为安全套坚持使用率48.303%；9.138%（35/383）与同性发生过商业性行为，安全套坚持使用率25.714%；4.702%（19/404）与异性发生过性行为，性行为时安全套坚持使用率42.105%。最近1年，无人自述被诊断过性病；77.475%（313/404）进行过HIV检测，每人检测1～10次不等，中位数2次（1，2），检测≥2次占87.859%。PEP知晓率77.723%（314/404），知晓者中网络知晓率46.178%、从MSM社会组织获取的知晓率30.892%、从医生处的知晓率22.930%。
2.2　MSM对PEP接受意愿的单因素分析（表1）
采用χ2检验进行单因素分析，婚姻状况（χ2=24.523）、文化程度（χ2=5.766）、月收入（χ2=5.359）、性取向（χ2=104.359）、最主要找男伴的场所（χ2=21.466）、HIV知识知晓（χ2=134.594）、肛交时性角色（χ2=10.938）、最近6个月同性性伴数量（χ2=8.644）、最近6个月与同性肛交安全套使用频率（χ2=4.424）、HIV检测次数（χ2=10.625）、PEP知晓（χ2=4.190）、可承担PEP最高价格（χ2=122.515）对PEP接受意愿差异均有统计学意义（P<0.050）。
2.3　PEP接受意愿多因素分析（表2）
多因素logistic回归结果显示，影响MSM对PEP接受意愿的主要因素为文化程度（OR=5.500，95%CI=2.174～13.911）、同性性伴数量（OR=21.708，95%CI=6.258～75.305）、最近6个月与同性肛交安全套使用频率（OR=9.301，95%CI=2.711～31.904）、HIV检测次数（OR=3.218，95%CI=1.500～6.904）。
3　讨　论
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本研究中MSM人群对PEP知晓率为77.723%，其知晓率低于广西MSM人群的调查结果（88.5%）[8]，这可能与黑龙江省PEP宣传覆盖面和宣传力度不够、临床医生对PEP工作了解程度不高、社会组织工作人员对此项工作宣传力度不够、部分地区还未将此项工作纳入常规的艾滋病防治宣传教育和综合干预内容有关。知晓者中46.178%从网络、30.892%从MSM社会组织、22.930%从医生处知晓，建议一方面加强网络媒体对PEP的宣传教育，另外一方面要充分发挥社会组织或志愿者和医疗机构的作用进行线上、线下宣传倡导，提高相关目标人群的知晓率，发生HIV暴露后能及时求医。PEP接受意愿率为68.812%，该接受意愿率高于广西和济南市的研究结果[8–9]，这可能是由于不同地区的经济文化水平、艾滋病的宣传教育内容以及当地MSM社会组织干预工作开展情况有所差异所致。
本研究的多因素logistic回归结果显示，与PEP接受意愿相关的因素为文化程度、同性性伴数量、最近6个月与同性肛交安全套使用频率和HIV检测次数。高中及以上文化程度对PEP的接受意愿比初中及以下低，与广西曾梓[10]和国外Ehui E [11]和 Mitchell J W[2]研究结果一致，这可能是因为高中及以上文化程度低MSM知识水平相对高，接受的HIV健康宣传教育较多，对其有客观的认知，自我保护意识较强，会采用安全套等措施来保护自己，认为其发生HIV暴露的风险性相对较小，也提示黑龙江省在针对不同文化程度的MSM人群在PEP的宣传力度和强度上要有所区别。性伴越多，HIV暴露的风险越高，其对PEP的需求就越高[10]，提示未来在HIV宣传策略中仍需要加强减少性伴和固定性伴的教育。与同性肛交不能坚持使用安全套的MSM相比坚持使用安全套的MSM对PEP接受意愿更高，这可能是因为坚持每次使用安全套的MSM认为安全套的使用成本远比PEP更低，安全套的防护效果也在以往的实践中得到广大MSM的认可[9]，提示在推广PEP的同时，也要加强对安全套使用的宣传和推广。HIV检测次数越多，其对暴露后预防用药服务的需求就越强，与Hou [12]的研究结果一致。经常接受 HIV 检测，一方面被认为更加关注自身健康，更有机会获得 PEP 相关知识宣传，相对自我防护意识较强，对自身健康状况（HIV检测）更加关心，因此也更愿意接受PEP来保护自己不受感染；另外一方面，检测次数越多，也可能提示其心理可能出现了问题，恐惧感、强迫症等，因此愿意接受更多的补救措施。
在全国艾滋病疫情中，男男同性性行为人群整体感染水平较高，且呈上升趋势。黑龙江省艾滋病疫情中，同性传播的占比远超全国平均水平，在干预工作中强调正确使用安全套、避免发生多性伴和无保护性行为是以往预防HIV感染最主要的措施，HIV暴露后预防用药作为传统行为干预措施的补充，未来可在继续开展HIV健康教育及强调安全套使用的基础上，在线上和线下加强对该人群关于HIV暴露后预防用药服务的宣传教育工作，同时对提供PEP服务的小组骨干、疾控工作人员及临床医生也应加强培训，使更多的目标人群了解并使用PEP，进一步减少MSM的HIV感染。
本研究存在局限性。一是横断面调查无法分析 PEP 用药使用意愿和相关因素的因果关系；二是滚雪球方法存在选择偏倚，本研究已通过选择不同特征及行为习惯的“种子”以及增加“种子”数量的方法，以减少选择偏倚；三是研究对象存在自我报告行为的信息偏倚。

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2025年第41卷第2期
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doi: 10.11847/zgggws1143678
  • 接收时间：2023-11-28
  • 首发时间：2026-10-25
  • 出版时间：2025-02-10
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  • 收稿日期：2023-11-28
  • 修回日期：2024-09-26
  • 录用日期：2024-11-21
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    黑龙江省疾病预防控制中心，哈尔滨 150030

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2种不同金属材料的力学参数
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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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