[HIV self-testing reagent use in pre-exposure prophylaxis and related factors in men who have sex with men]

Objective: To understand the current status of HIV self-testing reagent use in pre-exposure prophylaxis (PrEP) and related factors in men who have sex with men (MSM). Methods: From December 2018 to December 2019, "Gold data" online platform (www.jinshuju.com) was used to conduct multicenter PrEP studies in Shenyang, Beijing, Chongqing and Shenzhen of China. Results: A total of 1 222 MSM PrEP users were included in the multicenter study. The average age of the participants was (31.5±8.7) years, and the number of sexual partners in the past three months was 3 (P₂₅,P₇₅:2,6). The proportions of those who did not use condoms in anal sex with fixed, casual and commercial partners were 62.7% (456/727), 56.3% (440/781) and 41.0% (16/39), respectively. Up to 74.5% (910/1 222) of participants had used HIV self-testing reagents, and the number of HIV self-testing during last year was 3 (P₂₅,P₇₅:2,5). The multivariate logistic regression analysis indicated that compared with age group >40 years, those with education level of junior high school or below, those with psychological identity as female, event driven PrEP users, those never using new type drugs in past 3 months, the participants aged 18- years (aOR=2.06, 95%CI: 1.35-3.14), 26- years (aOR=2.72, 95%CI: 1.77-4.17), 31- years (aOR=1.76, 95%CI: 1.19-2.59), undergraduates (aOR=2.18, 95%CI: 1.35-3.49), graduate students and above (aOR=3.06, 95%CI: 1.69-5.54), those with psychological identity as male (aOR=3.22, 95%CI: 1.55-6.70), daily PrEP users (aOR=1.35, 95%CI: 1.03-1.78), and new type drug users in the past three months (aOR=1.72, 95%CI: 1.30-2.28) had higher proportions of HIV self-testing behaviors. Conclusions: The proportion of HIV self-testing in MSM PrEP users was high, while it was relatively low in older age group, event driven PrEP users and MSM never using new type drugs. To assess and improve the effectiveness and compliance of PrEPs, it is necessary to provide better HIV self-testing service for MSM with low HIV self-testing rate.

[Acceptability of pre-exposure HIV prophylaxis clinical trial among MSM in Shenyang city]

Objective: To investigate the acceptability and related factors of an "on-demand" pre-exposure prophylaxis (PrEP) to prevent HIV transmission among MSM in Shenyang. Methods: MSM recruited by non-probability sampling method and questionnaire survey conducted by investigators to collect information on social and behavioral characteristics, awareness of PrEP, Truvada and the acceptability of two different PrEP-based trials. Multivariate logistic regression was employed for statistical analysis. Results: Among the 292 respondents, 34.2% had heard of PrEP and 58.2% (170/292) reported were interested in participating a PrEP trial- "on-demand" use or 48.3% (141/292) interested on "daily" use (χ(2)=5.785, P=0.02). Factors independently associated with those "on-demand" would include: having more than 2 male sexual partners during the past 6 month (aOR=1.7, 95%CI: 1.1-2.7), concerning on the positive effect of PrEP (vs. side effects) (aOR=6.4, 95%CI:2.2-18.9), having an HIV-infected sexual partners (aOR=8.1, 95%CI: 1.0-63.3) and self-reported high risk for HIV (aOR=2.6, 95%CI: 1.2-6.0). The last two factors were only associated with the "on-demand" group. Conclusions: "On-demand" PrEP (as opposed to daily) seemed a more feasible prevention strategy on HIV and particularly in those having high risk behavior of HIV. For those who could not follow the daily medication or having HIV risk perception, "On-demand" basis PrEP trial should be recommended for them to follow.

[Bibliometric analysis on research hotspots on HIV post-exposure prophylaxis related articles in the world, 2000-2017]

Objective: To analyze and reveal the distribution, research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP), and provide information for related studies in China. Methods: CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017. Results: The average growth rate of international PEP-related papers was 10.78%,and number of published papers in 2016 was highest (n=34), relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk, such as MSM, in recent years. Clustering analysis classified research hotspots into three categories, including risk reduction through enhanced intervention, current status of global HIV PEP and German-Austrian Recommendation. Conclusions: Non-occupational HIV PEP in groups at high-risk, especially MSM, has received increasing attention in recent years, the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication. In the context of severe HIV epidemic in MSM without effective control in China, PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.