Background:Despite strengthened efforts on human immunodeficiency virus(HIV)prevention and control,new HIV infections continue to increase among men who have sex with men(MSM)in China.Pre-exposure prophylaxis(PrEP),a ...Background:Despite strengthened efforts on human immunodeficiency virus(HIV)prevention and control,new HIV infections continue to increase among men who have sex with men(MSM)in China.Pre-exposure prophylaxis(PrEP),a highly effective HIV-prevention tool,has recently been included in China’s Action Plan of HIV Prevention and Control.To promote future PrEP implementation,this study aims to identify the barriers and facilitators in PrEP use intention among MSM in China.Methods:In 2018,a cross-sectional survey was conducted among 300 MSM in Nanjing,Jiangsu Province.Questions on demographics,sexual behavior(including a seven-item high-risk behavior index),PrEP use intention,PrEP-related awareness and accessibility,and a seven-item public HIV stigma scale were included in the questionnaire.Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP use intention.Results:Overall,44.67%of the participants had more than two male sexual partners and 5.56%had HIV-positive sexual partners.Only 57.00%had heard of PrEP and only four(1.33%)participants had used PrEP.However,75.34%expressed the willingness to use oral PrEP if its efficacy was assured.The beliefs that“PrEP can prevent HIV if taken as prescribed”(adjusted odds ratio(AOR)=4.84,P<0.001)and“PrEP can be scaled up in the community”(AOR=3.24,P<0.001)were positively associated with oral PrEP use intention.Concerns of side effects were negatively associated with oral PrEP use intention(AOR=0.32,P=0.006).Further,77.00%of the participants would choose injectable or implanted PrEP instead of oral PrEP.One of the PrEP stigma items,“Not certain if doctors can prescribe PrEP if I go to the clinic”was positively associated with the intention to use injectable or implanted PrEP(AOR=3.03).The items“Heard of PrEP”(AOR=2.74)and“PrEP can prevent HIV if taken as prescribed”(AOR=2.65)were also positively related to the intention to use injectable or implanted PrEP.The most common concerns regarding PrEP use were efficacy(44.67%)and side effects(38.67%).The most common reasons for using injectable and implanted PrEP were adherence(81.94%and 77.86%,respectively)and privacy concerns(56.48%and 55.00%,respectively).Affordable price and coverage by health insurance were the driving factors for PrEP use.Conclusion:Given the low level of awareness of PrEP-related information in China,it’s necessary to provide interventions for high-risk individuals and communities,in order to increase their awareness and knowledge of PrEP.Furthermore,additional alternatives to HIV prevention,such as long-acting injectable or implanted PrEP,should be investigated to reduce the risk of HIV infection in at-risk MSM.Even if this programme could be approved by the National Medical Products Administration of China and implemented,a supportive social environment for MSM is essential during its implementing.展开更多
Background The global coronavirus disease 2019(COVID-19)has caused many negative effects on physical and mental health of patients who have survived COVID-19.Apart from some long-lasting physical sequelae,those COVID-...Background The global coronavirus disease 2019(COVID-19)has caused many negative effects on physical and mental health of patients who have survived COVID-19.Apart from some long-lasting physical sequelae,those COVID-19 survivors are also suffering stigma and discrimination at different levels around the world.The current study aims to assess the role resilience played in stigma and mental disorders among COVID-19 survivors.Methods The cross-sectional study was carried out among former COVID-19 patients in Jianghan District(Wuhan,China)from June 10 to July 25,2021.The demographic questions,the Impact of Events Scale-Revised,the Generalized Anxiety Disorder Questionnaire,the Patient Health Questionnaire,the Resilience Style Questionnaire and the Short Version of COVID-19 Stigma Scale of 12 items were used to collect relevant information of the participants.Descriptive analyses,Pearson correlation analysis and Structural Equation Modeling were used to make data description and analysis.Results A total of 1541 out of 1601 COVID-19 survivors(887 females and 654 males)were included in the analysis.Perceived stigma of those COVID-19 survivors correlates significantly with anxiety(r=0.335,P<0.001),depression(r=0.325,P<0.001)and post-traumatic stress disorder(PTSD)(r=0.384,P<0.001).It has a direct effect on COVID-19 survivors’anxiety(β=0.326,P<0.001),depression(β=0.314,P<0.001),PTSD(β=0.385,P<0.001)and their resilience(β=−0.114,P<0.01).Resilience partially mediated the association between perceived stigma and anxiety(β=0.020,P<0.01),depression(β=0.020,P<0.01),and PTSD(β=0.014,P<0.01)among COVID-19 survivors.Conclusion Stigma has a significant negative impact on mental health,while resilience plays a mediator role in the relationship between stigma and mental health among COVID-19 survivors.Based on our study,we suggested that when designing psychological interventions for COVID-19 survivors,consideration should be taken into account to reduce stigma and improve resilience.展开更多
基金This study was funded by the Innovative Engineering Program on global health policy sponsored by Chinese Academy of Medical Sciences(Grant No.2017-I2M-B&R-17).
文摘Background:Despite strengthened efforts on human immunodeficiency virus(HIV)prevention and control,new HIV infections continue to increase among men who have sex with men(MSM)in China.Pre-exposure prophylaxis(PrEP),a highly effective HIV-prevention tool,has recently been included in China’s Action Plan of HIV Prevention and Control.To promote future PrEP implementation,this study aims to identify the barriers and facilitators in PrEP use intention among MSM in China.Methods:In 2018,a cross-sectional survey was conducted among 300 MSM in Nanjing,Jiangsu Province.Questions on demographics,sexual behavior(including a seven-item high-risk behavior index),PrEP use intention,PrEP-related awareness and accessibility,and a seven-item public HIV stigma scale were included in the questionnaire.Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP use intention.Results:Overall,44.67%of the participants had more than two male sexual partners and 5.56%had HIV-positive sexual partners.Only 57.00%had heard of PrEP and only four(1.33%)participants had used PrEP.However,75.34%expressed the willingness to use oral PrEP if its efficacy was assured.The beliefs that“PrEP can prevent HIV if taken as prescribed”(adjusted odds ratio(AOR)=4.84,P<0.001)and“PrEP can be scaled up in the community”(AOR=3.24,P<0.001)were positively associated with oral PrEP use intention.Concerns of side effects were negatively associated with oral PrEP use intention(AOR=0.32,P=0.006).Further,77.00%of the participants would choose injectable or implanted PrEP instead of oral PrEP.One of the PrEP stigma items,“Not certain if doctors can prescribe PrEP if I go to the clinic”was positively associated with the intention to use injectable or implanted PrEP(AOR=3.03).The items“Heard of PrEP”(AOR=2.74)and“PrEP can prevent HIV if taken as prescribed”(AOR=2.65)were also positively related to the intention to use injectable or implanted PrEP.The most common concerns regarding PrEP use were efficacy(44.67%)and side effects(38.67%).The most common reasons for using injectable and implanted PrEP were adherence(81.94%and 77.86%,respectively)and privacy concerns(56.48%and 55.00%,respectively).Affordable price and coverage by health insurance were the driving factors for PrEP use.Conclusion:Given the low level of awareness of PrEP-related information in China,it’s necessary to provide interventions for high-risk individuals and communities,in order to increase their awareness and knowledge of PrEP.Furthermore,additional alternatives to HIV prevention,such as long-acting injectable or implanted PrEP,should be investigated to reduce the risk of HIV infection in at-risk MSM.Even if this programme could be approved by the National Medical Products Administration of China and implemented,a supportive social environment for MSM is essential during its implementing.
文摘Background The global coronavirus disease 2019(COVID-19)has caused many negative effects on physical and mental health of patients who have survived COVID-19.Apart from some long-lasting physical sequelae,those COVID-19 survivors are also suffering stigma and discrimination at different levels around the world.The current study aims to assess the role resilience played in stigma and mental disorders among COVID-19 survivors.Methods The cross-sectional study was carried out among former COVID-19 patients in Jianghan District(Wuhan,China)from June 10 to July 25,2021.The demographic questions,the Impact of Events Scale-Revised,the Generalized Anxiety Disorder Questionnaire,the Patient Health Questionnaire,the Resilience Style Questionnaire and the Short Version of COVID-19 Stigma Scale of 12 items were used to collect relevant information of the participants.Descriptive analyses,Pearson correlation analysis and Structural Equation Modeling were used to make data description and analysis.Results A total of 1541 out of 1601 COVID-19 survivors(887 females and 654 males)were included in the analysis.Perceived stigma of those COVID-19 survivors correlates significantly with anxiety(r=0.335,P<0.001),depression(r=0.325,P<0.001)and post-traumatic stress disorder(PTSD)(r=0.384,P<0.001).It has a direct effect on COVID-19 survivors’anxiety(β=0.326,P<0.001),depression(β=0.314,P<0.001),PTSD(β=0.385,P<0.001)and their resilience(β=−0.114,P<0.01).Resilience partially mediated the association between perceived stigma and anxiety(β=0.020,P<0.01),depression(β=0.020,P<0.01),and PTSD(β=0.014,P<0.01)among COVID-19 survivors.Conclusion Stigma has a significant negative impact on mental health,while resilience plays a mediator role in the relationship between stigma and mental health among COVID-19 survivors.Based on our study,we suggested that when designing psychological interventions for COVID-19 survivors,consideration should be taken into account to reduce stigma and improve resilience.
