Drug users’ perceptions, demands, and suggestions for non-occupational post-exposure prophylaxis (nPEP) services in China: a qualitative study

Abstract

Background Drug users are regarded as a high-risk population of HIV infection. Non-occupational post-exposure prophylaxis (nPEP) is internationally regarded as an effective biomedical prevention against HIV but still a small-scale pilot project in China at present. The aim of this study was to understand drug users’ perceptions demands and suggestions for nPEP service in China.Methods Nineteen eligible drug users were recruited in this qualitative study. Semi-structured in-depth interviews were conducted by trained interviewers. All of the interviews were audio-taped, transcribed verbatim and analyzed using thematic framework analysis.Results Most of participants had not heard of nPEP and none of them had used this service. After being informed basic knowledge of nPEP, about half of the participants reported willingness to use it. The facilitators included scare of HIV infection and regarding nPEP as a remedial measure in emergency. The barriers included low willingness for fatigue and lethargy after taking drugs, high price and side effects of nPEP medication, long course of nPEP treatment, and fear of privacy disclosure. Most of the participants thought the availability of nPEP would not increase the occurrence of unprotected intercourse and supported the routinization of nPEP services. Most participants chose social media for nPEP propaganda and pharmacies for providing nPEP.Conclusions It is imperative to strengthen propaganda and education of nPEP among drug users, and to encourage them to proactively use nPEP after exposure. Price regulation, side effect management and privacy protection need to be managed well when nPEP is routinized.