High HIV prevalence, low awareness of and willingness to use HIV pre-exposure prophylaxis among male migrant workers in Southwestern, China: a short report

Acceptability of HIV pre-exposure prophylaxis in China: A systematic review and meta-analysis

Using pre-exposure prophylaxis (PrEP) for the prevention of HIV infection is a popular, contemporary research topic. We retrieved PubMed, Web of Science, MEDLINE, Wanfang, CNKI, and Sinomed databases, and related websites to identify studies both in Chinese and English, which reported the acceptability of PrEP in China. A total of 3203 citations were retrieved, of which 54 were included. We found that the acceptability varied widely across the country, ranging from 19.1% to 94.6%, and the pooled estimate was 66.8% (95% CI: 62.0%–71.3%). Higher acceptability of PrEP was associated with the following factors: individuals with a lower educational degree, higher income, non-discriminatory attitude towards AIDS or AIDS patients, self-perceived high HIV risk, feeling that PrEP should be promoted, familiarity with PrEP, history of HIV testing, history of anal intercourse, consistent condom use, higher number of sexual partners. The main reasons for not using PrEP are doubting its validity, fear of potential side effects and financial burden, and fear of stigma for using PrEP. This review found that the acceptance in China was moderate.

Non-student young men put students at high risk of human immunodeficiency virus acquisition in Guangxi, China: a phylogenetic analysis of surveillance data

Background

We sought to identify students and their sexual partners in a molecular transmission network.

Methods

We obtained 5996 HIV protease and reverse transcriptase gene sequences in Guangxi (165 from students and 5831 from the general populations) and the relevant demographic data. We constructed a molecular transmission network and introduced a permutation test to assess the robust genetic linkages. We calculated the centrality measures to describe the transmission patterns in clusters.

Results

At the network level, 68 (41.2%) students fell within the network across 43 (8.1%) clusters. Of 141 genetic linkages between students and their partners, only 25 (17.7%) occurred within students. Students were more likely than random permutations to link to other students (odds ratio [OR], 7.2; P < .001), private company employees aged 16–24 years (OR, 3.3; P = .01), private company or government employees aged 25–49 years (OR, 1.7; P = .03), and freelancers or unemployed individuals aged 16–24 years (OR, 5.0; P < .001). At the cluster level, the median age of nonstudents directly linked to students (interquartile range) was 25 (22–30) years, and 80.3% of them had a high school or higher education background. Compared with students, they showed a significantly higher median degree (4.0 vs 2.0; P < .001) but an equivalent median Eigenvector Centrality (0.83 vs 0.81; P = .60).

Conclusions

The tendency of genetic linkage between students and nonstudent young men and their important position in the HIV transmission network emphasizes the urgent need for 2-pronged public health interventions based on both school and society.