Utilization of post-exposure prophylaxis potentially contributed to the changes of risk behaviors among men who have sex with men in China

Rong Su; Yi Liu; Peilong Li; Lin Ge; Meizhen Liao; Yong Fu; Xin Song; Houlin Tang; Dongmin Li

doi:10.3389/fpubh.2024.1364913

Utilization of post-exposure prophylaxis potentially contributed to the changes of risk behaviors among men who have sex with men in China

Front Public Health. 2024 Apr 8:12:1364913. doi: 10.3389/fpubh.2024.1364913. eCollection 2024.

Authors

Rong Su¹, Yi Liu¹, Peilong Li¹, Lin Ge¹, Meizhen Liao², Yong Fu³, Xin Song³, Houlin Tang¹, Dongmin Li¹

Affiliations

¹ National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
² Shandong Provincial Center for Disease Control and Prevention, Jinan, China.
³ Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China.

Abstract

Background: The HIV infection status among men who have sex with men (MSM) in China is a cause for concern. Post-exposure prophylaxis (PEP) serves as a highly effective biomedical preventive measure against HIV infection. Substantial evidence has established an association between PEP utilization and risk behaviors among MSM, but whether the utilization of PEP has an impact on risk behaviors remains unknown. This study sought to elucidate the impact of PEP usage on risk behaviors among MSM and provide recommendations for developing targeted HIV prevention programs.

Methods: A cohort study was conducted in Qingdao, China, from April 2021 to January 2022. Participants were enlisted by volunteers from community-based organizations through a snowball sampling method. Face-to-face interviews were conducted to collect sociodemographic and behavioral information of participants. The study encompassed a retrospective investigation, baseline survey, and follow-up survey, representing periods before, during, and after PEP usage, respectively. Generalized estimating equations, fitting a Poisson regression model, were applied to scrutinize changes in risk behaviors of MSM during and after PEP usage, in comparison to before PEP usage.

Results: A total of 341 MSM were recruited in the cohort study, with 179 individuals completing the follow-up survey. In comparison to before PEP usage, there was a significant increase in the proportion of Rush Popper usage (17.6% vs. 23.8% vs. 29.6%) and commercial sexual partners (10.9% vs. 17.6% vs. 21.8%) among MSM during and after PEP usage. Before PEP usage, 88.7% of MSM reported having ≥3 temporary sexual partners in the last 6 months. This proportion exhibited no significant change during PEP usage (91.8%), but it significantly increased to 97.8% after PEP usage (P < 0.05). Notably, there was a significant decrease in group sex during and after PEP usage compared to before PEP usage (30.8% vs. 21.4% vs. 21.2%).

Conclusion: The utilization of PEP may impact risk behaviors among MSM, potentially leading to increased Rush Popper usage, temporary sexual partners, and commercial sexual partners after PEP usage, accompanied by a decrease in group sex. Further research is imperative to elucidate the impact of PEP utilization on MSM and develop targeted HIV prevention programs.

Keywords: HIV; men who have sex with men; post-exposure prophylaxis; risk behaviors; utilization.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
China
Cohort Studies
HIV Infections* / prevention & control
Homosexuality, Male* / statistics & numerical data
Humans
Male
Middle Aged
Post-Exposure Prophylaxis* / statistics & numerical data
Retrospective Studies
Risk-Taking*
Surveys and Questionnaires
Young Adult

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Science and Technology Major Project (Grant No. 2017ZX10201101-002-005).