Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China

Abstract Background Men who have sex with men (MSM) are key populations for HIV infection. Post-exposure prophylaxis (PEP) has been confirmed to be an effective measure for preventing HIV transmission. This study aimed to investigate the usage of PEP among MSM in Qingdao and its associated factors,...

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Main Authors: Rong Su, Yi Liu, Peilong Li, Lin Ge, Meizhen Liao, Yong Fu, Xin Song, Houlin Tang, Dongmin Li
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10795-9
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author Rong Su
Yi Liu
Peilong Li
Lin Ge
Meizhen Liao
Yong Fu
Xin Song
Houlin Tang
Dongmin Li
author_facet Rong Su
Yi Liu
Peilong Li
Lin Ge
Meizhen Liao
Yong Fu
Xin Song
Houlin Tang
Dongmin Li
author_sort Rong Su
collection DOAJ
description Abstract Background Men who have sex with men (MSM) are key populations for HIV infection. Post-exposure prophylaxis (PEP) has been confirmed to be an effective measure for preventing HIV transmission. This study aimed to investigate the usage of PEP among MSM in Qingdao and its associated factors, analyze the impact of PEP usage on risk behaviors, and offer insights for HIV prevention. Methods Between April and August 2021, a cross-sectional survey was conducted in Qingdao, relying on local community-based organizations (CBOs) and employing a snowball sampling method to recruit eligible MSM. We gathered sociodemographic information, behavioral data, and PEP usage details from the participants. The analysis of factors associated with PEP utilization among MSM was performed using a logistic regression model. Subsequently, a follow-up visit was conducted six months later, collecting behavioral information from the participants. Generalized estimating equations fitting Poisson regression were utilized to analyze behavioral changes during the follow-up for PEP users and non-PEP users. Results A total of 602 MSM were enrolled in this study, with a median age of 30.0 years. Among them, 140 individuals used PEP in the last 6 months, resulting in a usage rate of 23.3% (140/602). Factors associated with PEP usage included monthly income ≥ 5000 RMB (aOR = 2.092, 95%CI: 1.366–3.203) and engaging in group sex ≥ 3 times in the last 6 months (aOR = 1.844, 95%CI: 1.067–3.189). In the follow-up survey, 467 individuals participated, comprising 112 PEP users and 355 non-PEP users. Compared to the baseline, the proportion of non-PEP users with Rush Popper usage frequency ≥ 1 time/week increased from 19.3% to 34.4% during follow-up (RR = 1.671, 95%CI: 1.302–2.146), and the proportion of those engaging in unprotected anal intercourse in the past 6 months increased from 95.5% to 98.6% (RR = 1.029, 95%CI: 1.004–1.056). However, the risk behaviors of PEP users exhibited no significant changes during the study period (P > 0.05). Conclusions Higher frequency of group sex and higher monthly income emerged as facilitating factors for PEP usage among MSM in Qingdao. Beyond its efficacy in preventing HIV infection, PEP may also play a role in managing the occurrence of risk behaviors among MSM. Consequently, there is a pressing need to intensify efforts to promote PEP uptake among MSM as a strategy to control the spread of HIV.
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spelling doaj-art-4b283e43b3ec421e8b42da66e438593d2025-08-20T02:49:29ZengBMCBMC Infectious Diseases1471-23342025-03-012511810.1186/s12879-025-10795-9Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, ChinaRong Su0Yi Liu1Peilong Li2Lin Ge3Meizhen Liao4Yong Fu5Xin Song6Houlin Tang7Dongmin Li8National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and PreventionNational Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and PreventionNational Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and PreventionNational Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and PreventionShandong Center for Disease Control and PreventionQingdao Center for Disease Control and PreventionQingdao Center for Disease Control and PreventionNational Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and PreventionNational Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and PreventionAbstract Background Men who have sex with men (MSM) are key populations for HIV infection. Post-exposure prophylaxis (PEP) has been confirmed to be an effective measure for preventing HIV transmission. This study aimed to investigate the usage of PEP among MSM in Qingdao and its associated factors, analyze the impact of PEP usage on risk behaviors, and offer insights for HIV prevention. Methods Between April and August 2021, a cross-sectional survey was conducted in Qingdao, relying on local community-based organizations (CBOs) and employing a snowball sampling method to recruit eligible MSM. We gathered sociodemographic information, behavioral data, and PEP usage details from the participants. The analysis of factors associated with PEP utilization among MSM was performed using a logistic regression model. Subsequently, a follow-up visit was conducted six months later, collecting behavioral information from the participants. Generalized estimating equations fitting Poisson regression were utilized to analyze behavioral changes during the follow-up for PEP users and non-PEP users. Results A total of 602 MSM were enrolled in this study, with a median age of 30.0 years. Among them, 140 individuals used PEP in the last 6 months, resulting in a usage rate of 23.3% (140/602). Factors associated with PEP usage included monthly income ≥ 5000 RMB (aOR = 2.092, 95%CI: 1.366–3.203) and engaging in group sex ≥ 3 times in the last 6 months (aOR = 1.844, 95%CI: 1.067–3.189). In the follow-up survey, 467 individuals participated, comprising 112 PEP users and 355 non-PEP users. Compared to the baseline, the proportion of non-PEP users with Rush Popper usage frequency ≥ 1 time/week increased from 19.3% to 34.4% during follow-up (RR = 1.671, 95%CI: 1.302–2.146), and the proportion of those engaging in unprotected anal intercourse in the past 6 months increased from 95.5% to 98.6% (RR = 1.029, 95%CI: 1.004–1.056). However, the risk behaviors of PEP users exhibited no significant changes during the study period (P > 0.05). Conclusions Higher frequency of group sex and higher monthly income emerged as facilitating factors for PEP usage among MSM in Qingdao. Beyond its efficacy in preventing HIV infection, PEP may also play a role in managing the occurrence of risk behaviors among MSM. Consequently, there is a pressing need to intensify efforts to promote PEP uptake among MSM as a strategy to control the spread of HIV.https://doi.org/10.1186/s12879-025-10795-9HIVPost-exposure prophylaxisMen who have sex with menUtilizationRisk behaviors
spellingShingle Rong Su
Yi Liu
Peilong Li
Lin Ge
Meizhen Liao
Yong Fu
Xin Song
Houlin Tang
Dongmin Li
Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China
BMC Infectious Diseases
HIV
Post-exposure prophylaxis
Men who have sex with men
Utilization
Risk behaviors
title Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China
title_full Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China
title_fullStr Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China
title_full_unstemmed Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China
title_short Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China
title_sort usage of post exposure prophylaxis and its impact on risk behaviors among men who have sex with men in qingdao china
topic HIV
Post-exposure prophylaxis
Men who have sex with men
Utilization
Risk behaviors
url https://doi.org/10.1186/s12879-025-10795-9
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