Factors Influencing the Use of Pre-exposure Prophylaxis Among Men Who Have Sex with Men with Sexual Concurrency

Objective To analyze the use of pre-exposure prophylaxis (PrEP) and its influencing factors among men who have sex with multiple partners (MSM) in Shandong Province, in order to increase the use rate of PrEP and reduce the risk of HIV transmission.Methods The RDS subject driven sampling method was used to recruit 352 MSM partners from May to July 2024 to collect basic information, sexual network status, and pre-exposure prophylaxis use of participants. R software was used to explore the influencing factors of PrEP use through one-way ANOVA and multivariate Bayesian regression model.Results Among 352 MSM with multiple sex partners, PrEP use was 28.7%, the study found. Factors promoting PrEP use included self-assessment of high HIV risk (aOR=3.87, 95%CrI: 1.88-7.12), knowledge of PrEP (aOR=8.08, 95%CrI: 3.79-15.72), having partners who are HIV-positive or of unknown HIV status (aOR=2.62, 95%CrI: 1.17-5.07), engaging in unprotected anal intercourse (aOR=2.55, 95%CrI: 1.10-5.06), having partners who use drugs (aOR=1.93, 95%CrI: 0.92-3.63), and participation in peer education (aOR=12.15, 95%CrI: 1.49-52.91). Conversely, individuals residing in rural areas (aOR=0.33, 95%CrI: 0.09-0.88), with an education level below a bachelor's degree (aOR=0.47, 95%CrI: 0.02-0.92), with a monthly income of ≤3000 yuan (aOR=0.33, 95%CrI: 0.08-0.94), and those experiencing PrEP-related stigma (aOR=0.26, 95%CrI: 0.09-0.55) were less likely to use PrEP.Conclusion The current PrEP usage rate among MSM with multiple sexual partners in Shandong Province remains low. It is essential to enhance education and outreach, particularly for those in rural areas, with lower income and education levels, who have drug-using partners, and engage in high-risk sexual behaviors, to improve PrEP awareness and accessibility, thereby increasing PrEP coverage.