provinces in China announced the public health emergency. Psychological distress in the general population has been reported in China during the COVID-19 quarantine [1]. The healthcare system in Wuhan was quickly overwhelmed as tens of thousands of people with flu-like symptoms swarmed the hospitals. Frontline healthcare workers (HCWs) in Wuhan have been under tremendous pressure and risk of contracting COVID-19 since the beginning of the quarantine. As of February 12, 2020, 21,569 HCWs from other cities in China have been deployed to support emergency response efforts in Wuhan [2], while 1716 HCWs have contracted COVID-19 and 5 have died [3]. Two nurses Note. * p < .05, ** p < .01, *** p < .001.
Introduction
HIV incidence among men who have sex with men (MSM) is high in China. Pre‐exposure prophylaxis (PrEP) is a promising mean to prevent HIV transmission but it is not widely available in China. We conducted a large Internet‐based online survey to assess the willingness of Chinese MSM to take PrEP and associated factors to their uptake preferences.MethodsBetween 19 January and 6 February, 2017, 4581 MSM aged over 15 years were recruited via a social networking app to take an online PrEP survey. HIV status at the time of the survey being conducted was not one of recruitment criteria. Participants were asked if they had heard of PrEP, if they had concerns about PrEP, and if they would be ready to uptake PrEP should it be provided. When asked if participants were willing to take PrEP, they were asked to select from the following responses: “definitely not,” “probably not,” “not sure,” “probably yes,” and “definitely yes.” In the final analysis, we grouped these five‐level Likert scale responses into three‐level responses as “definitely yes,” “probably yes,” and “no (definitely not/probably not/not sure).” Descriptive analysis and multinomial logistic regressions were conducted to assess the associations of PrEP adoption readiness and uptake concerns with HIV risk behaviours and demographic characteristics.Results
MSM from 33 geographical regions of China participated in the survey. The majority were younger than 25 (65.2%) and had attended college (68.6%). HIV prevalence was high (6.8%) and 43.3% reported a history of unprotected anal sex. Only 22.4% of participants had heard of PrEP. When asked if they would uptake PrEP, 26.0% said “definitely yes,” 49.6% were “probably yes,” and 24.4% said “no.” PrEP adoption readiness was associated with having previously heard of PrEP and expressing concerns about accessibility and cost. Worries about side effects, low perceived HIV risk, preference for condoms, and never having received HIV testing were negatively associated with PrEP uptake willingness.ConclusionYoung and well‐educated Chinese MSM reported a low willingness to uptake PrEP despite being high‐risk for HIV. Effective education, especially through online mediums, will be critical to optimize this group's PrEP uptake.
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