HIV non-occupational post-exposure prophylaxis (nPEP) awareness and promotion among five key populations in China: A cross-sectional study

Li, Haochu; Piqueiras, Eduardo; Chow, Eric P F; Jiao, Kedi; Lewis, Taylor; Ma, Wei

doi:10.1016/j.lanwpc.2020.100086

Cited by 3 publications

(5 citation statements)

References 23 publications

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“…This study is the first to look at PEP and PrEP knowledge and use outside the MSM community and adds to the body of evidence of these subjects in Europe. Low percentages of knowledge and use of both prevention tools were also found among key populations in both the United States (20) and China (21), although the use of both tools in our sample is lower than that reported in those studies.…”

Section: Discussioncontrasting

confidence: 81%

Knowledge and Use of PEP and PrEP Among Key Populations Tested in Community Centers in Portugal

Simões

Meireles

Rocha³

et al. 2021

Front. Public Health

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Background: Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have been increasingly available in Europe. Due to the high burden of HIV in key populations, these could benefit from their use. In 2016, in Portugal, an open, non-interval, prospective cohort study was established in a network of 26 community-based voluntary HIV/STI counseling and testing centers. Data collected included questions on PEP and PrEP knowledge and use. We aimed to estimate the proportion of PEP and PrEP knowledge and its use among key populations, visiting the centers between 2016 and 2019.Method and results: Individuals who self-identify as being among at least one key population for HIV, men who have sex with men (MSM), people who inject drugs (PWID), sex workers (SW), migrants, and male-to-female transgender individuals (MTF), responded to questions on PEP and PrEP knowledge and use while waiting for their test results between 2016 and 2019 (n = 12,893 for PEP; n = 10,973 for PrEP). Reported knowledge was low in all key populations for both tools: 15.7% of respondents reported knowing about PEP and 10.9% about PrEP over the course of 4 years. PEP was used by 1.8% and PrEP by 0.4% of the respondents, MSM being 88.9% of PrEP users, and 52.8% of PEP users. Multivariate logistic regression showed multiple factors associated with knowing the tools, including age, education, country of birth, gender, year of test, having a reactive HIV test in the same visit, reporting an STI or condomless sex in the last 12 months, and identifying with being MSM or SW.Conclusions: Knowledge and use of PEP and PrEP remain low among key populations in Portugal. The need remains to increase knowledge and use among those at risk for HIV infection.

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Section: Discussioncontrasting

confidence: 81%

Knowledge and Use of PEP and PrEP Among Key Populations Tested in Community Centers in Portugal

Simões

Meireles

Rocha³

et al. 2021

Front. Public Health

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“…The frequency of consistent condom use in this study was higher than that reported in similar studies conducted in China10 15 and other countries 13 16. This could have been owing to the high level of HIV knowledge and awareness of partners’ infection status, both of which are related to less-risky sexual behaviours 12 17 18.…”

Section: Discussioncontrasting

confidence: 75%

Sexual behaviours and correlates of condom use among HIV-discordant couples from eastern China: a cross-sectional study

Zhang

Zheng-dong

et al. 2023

BMJ Open

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ObjectivesTo investigate sexual behaviours among HIV-discordant heterosexual couples and assess the correlates of condom use at the couple level.DesignCross-sectional study.SettingSeven prefectures along the Yangtze River in the Anhui Province, China.ParticipantsWe included 412 participants aged 18 years or older (206 married HIV-discordant couples).Primary and secondary outcome measuresIn this study, sexual behaviours included marital or extramarital sex in the past 6 months, as well as the frequency of marital sex and condom use (always, sometimes or never) if having marital sex in the past 6 months. We used stepwise ordinal logistic regression modelling to determine the correlates of condom use.ResultsIn total, 63.1% (130 of 206) of couples had marital sex in the past 6 months, of which 89.2% (116 of 130) used condoms consistently. Couples with more marital duration (OR=1.15; 95% CI: 1.03, 1.28) were more inclined to adhere to condom use, whereas those lacking support and care (OR=0.25; 95% CI: 0.07, 0.94) and being remarried (OR=0.08; 95% CI: 0.02, 0.43) were associated with less condom use. In addition, HIV-positive respondents were more likely to have extramarital sex than HIV-negative respondents (p=0.015).ConclusionsThe extramarital sex of HIV-positive spouses should be considered. Implementation of interventions, such as increasing support and care between spouses to promote marital intimacy and stability, could reduce unprotected sexual behaviour.

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“…Without an internet medical platform, individuals have to first recognize their potential risk of exposures, make decisions on seeking PEP service with great uncertainty, find the designated hospitals, visit the hospital during its working hours, get prescription from doctors, and obtain medicines; importantly, all of these activities should be completed within 72 hours of exposure, reflecting the inherent limitations of PEP service [ 19 , 46 ]. Moreover, as the effectiveness of PEP largely depends on timeliness of regimen initiation, to better improve the online PEP service model, future educational campaigns should focus more on ways to shorten the time from exposure to decision making on PEP use, to help patients initiate PEP treatment as early as possible because this not only helps reduce anxiety and fear among patients, but also is beneficial to ensure effectiveness of the therapeutic prevention.…”

Section: Discussionmentioning

confidence: 99%

“…As a biomedical HIV prevention strategy, nonoccupational HIV postexposure prophylaxis (PEP) has been proven to be a safe and effective strategy aimed at preventing HIV among those with a recent HIV exposure [10][11][12][13]. Currently, PEP has been widely implemented in many countries [14][15][16][17]; however, it remains an underutilized prevention strategy in China [18,19]. Between 2018 and 2019, the National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention (NCAIDS, China CDC) carried out a pilot program of PEP among MSM in 7 provinces to promote the uptake of PEP and preexposure prophylaxis (PrEP) [20].…”

Section: Introductionmentioning

confidence: 99%

“…Yet, due to the lack of sufficient research data, the Chinese Guideline on HIV PEP has not been formulated until October 2020 [21]. To date, the few published studies on HIV PEP in China have mainly focused on awareness and willingness to take PEP among high-risk populations, which showed that over one-half of the MSM were aware of PEP, with more than 60% highlighting the need for improved PEP access [19,22,23]. The findings of several other pilot studies in China also showed a high demand for PEP among MSM [24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

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Understanding the Uptake and Outcomes of Non-occupational Postexposure Prophylaxis Use Through an Online Medical Platform in China: Web-Based Cross-sectional Study

Shan¹,

Xue²,

Kai³

et al. 2023

J Med Internet Res

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Background To date, non-occupational postexposure prophylaxis (PEP) has been widely accepted as a safe and effective intervention for HIV in many countries, yet it remains an underutilized prevention strategy in China. Evidence indicated a high demand for PEP among Chinese men who have sex with men, but the uptake and access to PEP service remain limited. In an era of rapid development of web-based technology, online medical platforms in China hold great promise in facilitating PEP provision and delivery by addressing problems such as accessibility, convenience, privacy protection, and antidiscrimination by integrating online and offline resources. However, there is a paucity of data concerning the uptake and outcomes of online PEP in China. Objective The aim of this study is to explore online PEP service provision and understand PEP uptake and outcome through a web-based cross-sectional study. Methods From January 2020 to June 2021, we conducted a retrospective web-based survey among those seeking online PEP services via the internet medical platform “HeHealth” using a structured questionnaire. Participants were surveyed on sociodemographic characteristics, sexual and drug-related behaviors, history of preexposure prophylaxis (PrEP) usage, and PEP uptake. Statistical analysis included descriptive analysis, chi-square test, and multivariable logistic regression. P values <.05 were deemed statistically significant. Results No HIV seroconversions were observed among 539 PEP users. Our sample demonstrated that most participants seeking online PEP services were gay (397/539, 73.7%), single (470/539, 87.2%), having an education of more than 12 years (493/539, 91.5%), and with an average monthly income of 7000 RMB (1 RMB=US $0.14) or more (274/539, 50.8%). Sexual exposures accounted for 86.8% (468/539) of the cases, with anal sex being the most common indication (389/539, 72.2%) for seeking PEP use. Among 539 participants, 60.7% (327/539) sought online PEP for relatively low-risk exposures, whereas 39.3% (212/539) were considered high-risk exposures. Nearly all (537/539, 99.6%) initiated PEP within 72 hours and 68.6% (370/539) within 24 hours of exposure. All users (539/539) were prescribed a 3-drug regimen, with most comprising 3TC/TDF+DTG (lamivudine, tenofovir disoproxil fumarate, and dolutegravir; 293/539, 54.4%), followed by FTC/TDF+DTG (emtricitabine, tenofovir disoproxil fumarate, and dolutegravir; 158/539, 29.3%). The adjusted model showed that greater odds of PrEP usage were associated with an age of 35 years or older versus the age group of 25-34 years (adjusted odds ratio [AOR] 2.04, 95% CI 1.24-3.37), having an education of 17 years or more versus an education of 12 years or less (AOR 3.14, 95% CI 1.29-7.62), average monthly income of 20,000 RMB or more versus less than 3000 RMB (AOR 2.60, 95% CI 1.09-6.23), and having high-risk sexual behavior during PEP treatment (AOR 2.20, 95% CI 1.05, 3.69). Conclusions The 0% infection rate in this study demonstrated that online PEP could be a valuable risk-reduction option to improve HIV prevention service within China. However, further research is needed to better facilitate PrEP transition among online PEP users.

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HIV non-occupational post-exposure prophylaxis (nPEP) awareness and promotion among five key populations in China: A cross-sectional study

Cited by 3 publications

References 23 publications

Knowledge and Use of PEP and PrEP Among Key Populations Tested in Community Centers in Portugal

Knowledge and Use of PEP and PrEP Among Key Populations Tested in Community Centers in Portugal

Sexual behaviours and correlates of condom use among HIV-discordant couples from eastern China: a cross-sectional study

Understanding the Uptake and Outcomes of Non-occupational Postexposure Prophylaxis Use Through an Online Medical Platform in China: Web-Based Cross-sectional Study

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