title: Low willingness and actual uptake of pre-exposure prophylaxis for HIV-1 prevention among men who have sex with men in Shanghai, China.
abstract: Little is known about the acceptance and actual uptake of pre-exposure prophylaxis (PrEP) and associated factors in men who have sex with men (MSM) in China. This study is the baseline survey of an intervention study designed to evaluate the effectiveness of tenofovirdisoproxil fumarate (TDF) on a daily use for human immunodeficiency virus (HIV) prevention among MSM in Shanghai, China. From October 2012 to December 2013, a total of 1,033 MSM in Shanghai were recruited by local district Centers for Disease Control and Prevention (CDC) and a MSM community-based non-governmental organization (NGO). Among them, 197 (19.1%) participants expressed willingness to use the TDF group at baseline survey, but only 26 (2.5%) participated in the TDF group and took TDF one tablet a day. Higher willingness to use PrEP was associated with being 45 years or older, non-local residents, having more male sex partners in the past 6 months and not using condom at last anal sex with man. Acutal uptake of PrEP was associated with having ≥ 11 male sex partners in lifetime and reporting no female sex partners in lifetime. Reasons for not participating in TDF group among those who expressed willingness to use PrEP at baseline survey included loss of contact, ineligiblity because of abnormal results for liver or renal function tests, change of mind, and HIV seroconversion before uptake of PrEP. Our findings suggest that promotion of PrEP in MSM remains challenging at current circumstancein China. Future research is needed to solicit effective education and intervention programs to promote acceptance of PrEP among Chinese MSM.
authors.affiliation: Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Ding
authors.forename: Huamei
authors.initials: H
authors.lastname: Yan
authors.forename: Zhen
authors.initials: Z
authors.lastname: Ning
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Cai
authors.forename: Yin
authors.initials: Y
authors.lastname: Yang
authors.forename: Rong
authors.initials: R
authors.lastname: Pan
authors.forename: Yanqiu
authors.initials: Y
authors.lastname: Zhou
authors.forename: Huang
authors.initials: H
authors.lastname: Zheng
authors.forename: Meiyang
authors.initials: M
authors.lastname: Gao
authors.forename: Keming
authors.initials: K
authors.lastname: Rou
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
authors.forename: Na
authors.initials: N
authors.lastname: He
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002681:China; D015658:HIV Infections / Q000517:prevention & control*; D015497:HIV-1; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance; D065129:Pre-Exposure Prophylaxis; D012725:Sexual Behavior; D000068698:Tenofovir / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D000068698:Tenofovir