HIV non-occupational postexposure prophylaxis (nPEP) usage among five key populations in China

Abstract

ObjectivesTo examine the feasibility of non-occupational postexposure prophylaxis (nPEP) as a national strategy for HIV prevention in China, we investigated nPEP usage and related sociodemographic and behavioural factors among five key populations at high risk of contracting HIV.MethodsWe conducted a cross-sectional study among five key populations from November 2018 to September 2019 in China using convenience sampling to recruit participants aged ≥18 years, self-reporting HIV status as either negative or unknown and providing written informed consent. Univariable and multivariable logistic regression models were fitted.ResultsOur analysis included data from 2022 participants with a mean age of 35 years (SD=11.62). Only 57 (2.82%) participants had ever used nPEP. Sociodemographic and behavioural factors related to nPEP usage included populations (p<0.0001), age (p<0.05), education (p<0.05), nPEP knowledge (p<0.01), receiving conventional HIV prevention services (p<0.05) and HIV testing (p<0.05). A significant percentage (26%) of nPEP users used nPEP medication more than once. Challenges and concerns, such as multiple use of nPEP and syndemic conditions, were emerging.ConclusionsKey populations in China had low nPEP usage rates. Female sex workers, people who use drugs, older and illiterate individuals with poor nPEP knowledge, not using HIV prevention services or never tested for HIV should be emphasised. Implementing nPEP services would be an important way to access high-risk individuals for intensive and tailored HIV prevention and intervention. Challenges of providing nPEP services and future study foci are highlighted.

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

“…In this study, 97.0% (523/539) of PEP users presumably completed the full 28-day course of medication, and this rate was higher than the completion rates in 2 other Chinese studies, where 86% [47] and 92.2% [41] of PEP users completed the 28-day course of medication, respectively. Furthermore, a systematic review and meta-analysis of 97 studies worldwide showed an even lower rate of PEP completion (67.2%; 95% CI 59.5%-74.9%) [48].…”

The impact of COVID-19 non-pharmaceutical interventions on HIV care continuum in China: An interrupted time series analysis

“…In addition, we found that the decline in PEP prescriptions during the COVID-19 pandemic occurred primarily in people aged 50 years and younger, which may be because older adults are less adaptive to this unconventional and underutilized HIV prevention measure in China. A study in ten Chinese cities 36 found people aged 50-64 years were less likely to use non-occupational postexposure prophylaxis (nPEP) (OR 0·179, 95% CI 0·036-0·894) compared to those aged 18-34 years, although it was not statistically significant for those aged 65 years and older (OR 0·232, 95% CI 0·014-3·975). As travel restrictions were attenuated and social life gradually returned to normal, people may resume their previous sexual frequency and risk.…”

Analysis on epidemiological characters and HIV care continuum of HIV-infected students: a retrospective cohort study in Shandong province, China

“…High-risk behaviors during them such as unprotected sex, multiple sex partners and temporary partner [ 35 – 37 ] still occurred due to the separation of knowledge, belief and practice. And this group is harder to reach for CDC staffs, some people reached the populations through collaboration with gay-friendly CBO [ 38 ].Non-occupational postexposure prophylaxis (nPEP) was an effective means of prevention [ 39 ], but the cost was high for students. Treatment and care interventions are still effective interventions for these populations.…”