影响男男性行为者使用暴露前预防用药的质性研究

孙咏冰; 宋兵; 姜天俊

doi:10.16766/j.cnki.issn.1674-4152.004462

影响男男性行为者使用暴露前预防用药的质性研究

doi: 10.16766/j.cnki.issn.1674-4152.004462

解放军总医院第五医学中心感染病医学部, 北京 100039

基金项目:

国家重点研发计划项目 2022YFC2305004

详细信息

通讯作者:
姜天俊, E-mail：aba302@163.com

中图分类号: R512.91 R167
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- 文章访问数: 4
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出版历程
- 收稿日期: 2025-01-14

A qualitative study on the use of pre-exposure prophylaxis for men who have sex with men

Senior Department of Infectious Diseases, the Fifth Medical Center of PLA General Hospital, Beijing 100039, China

摘要

摘要: 目的我国人类获得性免疫缺陷病毒(human immunodeficiency virus, HIV)的防控形势仍然面临着一定的挑战。目前男男性行为者(men who have sex with men, MSM)成为我国努力遏制HIV传播的关键人群之一。为了控制HIV在MSM中的传播，实施暴露前预防(pre-exposure prophylaxis, PrEP)是一种重要的预防措施。但PrEP在我国MSM中的使用率仍然较低。本研究通过与MSM人群的访谈，了解阻碍其使用PrEP的原因。方法根据信息饱和原则，于2023年4—8月在北京艾滋病公益组织招募10位MSM实施访谈。采用7步主题分析的质性研究方法，对访谈资料进行归纳总结并提炼主题。结果共有10位MSM参与本研究中，年龄为21~53岁，有6人接受过高等教育，有6人月收入为5 000~10 000元。通过对资料的归纳与凝练，产生10个子主题，分别为知晓水平、宣传、预防其他传染病、激情、行为去抑制、药物副作用、服药方式、药物获取途径、药费及福利。经过进一步的总结，产生3个主题，分别为认知主题、性与药物主题、经济主题。结论 PrEP在我国的全面实施仍然面临着一定的困难，如我国MSM对PrEP的认识不足，担心预防疾病单一，忘记服药，药物副作用，费用高等问题。建议多渠道推广，丰富内容，加强同伴教育。同时充分发挥MSM公益组织的作用，关注MSM人群的传染病防控认知水平及心理健康水平。希望能够发挥公益组织的力量促进PrEP的实施方案能够更快传播。
- 男男性行为者 /
- 质性研究 /
- 暴露前预防 /
- 人类获得性免疫缺陷病毒
Abstract: Objective The prevention and control of human immunodeficiency virus (HIV) in China still faces significant challenges. Currently, men who have sex with men (MSM) have become one of the key populations in efforts to reduce HIV transmission. To control HIV transmission among MSM, pre-exposure prophylaxis (PrEP) serves as a crucial preventive measure. However, the uptake of PrEP among MSM in China remains low. This study aimed to explore the barriers to PrEP use among MSM through qualitative interviews. Methods Following the principle of information saturation, 10 MSM were recruited from an HIV-focused non-governmental organization in Beijing between April and August 2023 for in-depth interviews. A qualitative research approach using 7-step thematic analysis was employed to summarize and extract key themes from the interview data. Results A total of 10 MSM participated in the study, with ages ranging from 21 to 53 years. Six participants had received higher education, and six reported a monthly income of 5 000-10 000 RMB. Through data analysis, 10 subthemes were identified: awareness level, publicity, prevention of other infectious diseases, passion, behavioral disinhibition, drug side effects, dosing regimen, drug accessibility, cost, and benefits. These subthemes were further consolidated into three overarching themes: cognitive factors, sex and drug-related factors, and economic factors. Conclusion The comprehensive implementation of PrEP in China still encounters considerable challenges. Chinese MSM exhibit insufficient knowledge of PrEP, concerns regarding its limited scope of disease prevention, memory lapses in medication compliance, fear of side effects, and high costs. It is recommended to promote PrEP through multiple channels, enrich educational content, and strengthen peer-led initiatives. Additionally, the role of MSM-focused NGOs should be leveraged to enhance awareness of infectious disease prevention and mental health support within this population. Harnessing the influence of these organizations may accelerate the dissemination and adoption of PrEP strategies.
- Men who have sex with men /
- Qualitative research /
- Pre-exposure prophylaxis /
- Human immunodeficiency virus
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表 1 MSM人群对PrEP认知水平及使用决策的影响因素的访谈提纲

Table 1. Interview outline on factors influencing PrEP awareness and use decision-making among MSM populations

项目	内容
基本信息	年龄
	工作
	收入
	学历
	性角色
	性伴个数
	性爱频率
关于PrEP的半开放话题	您是从哪里了解PrEP相关信息的？
	您认为什么阻碍了使用PrEP？
	您认为应该如何更好的普及PrEP？
	您认为如何更好的提供这些服务？

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表 2 10名来访者一般资料

Table 2. General characteristics of 10 interviewees

编号	年龄	工作	收入(元)	学历	性角色	性伴个数	性爱频率(平均)
A1	22	饭店服务员	3 500	中专	1	固定伴侣5个不固定伴侣无	一周一次
A2	28	硬件测试	8 000~ 10 000	大专	0.5	固定伴侣1个不固定伴侣多个	两周一次
A3	21	大学生	无	本科	1	固定伴侣2个不固定伴侣无	半年一次
A4	42	超市工作人员	4 000	初中	0.5	固定伴侣1个不固定伴侣多个	一周一次
A5	53	中医按摩师	5 000~ 6 000	高中	1	固定伴侣1个不固定伴侣多个	不固定，有客人愿意就可以
A6	39	技术员	9 000	大专	0	固定伴侣1个不固定伴侣多个	一周两次
A7	23	保安	5 500	大专	1	固定伴侣1个不固定伴侣多个	至少一周一次
A8	35	建筑工程师	8 000	本科	1	固定伴侣1个不固定伴侣多个	一周一次
A9	41	电商	20 000	研究生	0	固定伴侣1个不固定伴侣多个	一周一次
A10	45	采购	5 000	初中	1	固定伴侣1个不固定伴侣多个	一周一次

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