Awareness, willingness, and status of using HIV pre-exposure prophylaxis among men who have sex with men in Shaanxi Province

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Objective: To analyze awareness, willingness, the status of using, and related factors of HIV pre-exposure prophylaxis (PrEP) in men who have sex with men (MSM) in Shaanxi Province to provide a reference for the next step of HIV prevention and control strategy. Methods: Using a cross-sectional study design from March to May 2022, with the assistance of MSM social organizations in Xi'an, relying on the network platform and MSM Social organizations, a convenient sampling method was used to recruit MSM with an estimated sample size of 900. The inclusion criteria were male aged ≥18, having had same-sex sexual intercourse in the last twelve months, HIV-negative or unknown status of infection. An electronic questionnaire was made with the help of questionnaire-star and an anonymous self-administered questionnaire was used to collect information on socio-demographic characteristics, sexual behavior, awareness and using of PrEP, etc. A logistic regression model was used to analyze related factors of PrEP awareness and use in MSM. SPSS 25.0 software was used for statistical analysis. Results: Among 981 MSM subjects, 76.55% (751/981) had heard of PrEP, and 42.51% (417/981) were aware of PrEP. Among those who knew about PrEP, 74.34% (310/417) had homosexual sexual activity in the last six months, 99.03% (307/310) were willing to use PrEP, and 40.97% (127/310) were using PrEP. The multivariate logistic regression analysis model results showed that nationality (other ethnic groups:aOR=4.48,95%CI:1.28-15.68),education level (high school or technical secondary school: aOR=3.01,95%CI:1.49-6.07; universities or colleges: aOR=2.86,95%CI:1.47-5.57; master degree: aOR=5.10,95%CI:2.37-10.98), monthly income 5 000-10 000 yuan (aOR=1.70,95%CI: 1.00-2.88), tested for HIV in the past 12 months (aOR=1.87,95%CI:1.34-2.61) were related factors of PrEP knowledge awareness. Singlehood (aOR=0.46,95%CI:0.26-0.81) and consulted professionals about PrEP (aOR=9.56,95%CI:4.58-19.96) were related factors of PrEP use. Conclusions: The proportion of willingness to use PrEP was higher among MSM in Shaanxi Province, but the awareness rate and utilization rate of MSM for PrEP were low. The cognition of PrEP should be further improved to promote the correct use of PrEP among MSM.