Background
Methods
Participants and data collection
Measures
Design of the questionnaire
Socio-demographics, utilization of HIV prevention services, sexual behaviors and mental health status
Patterns of SDU
PrEP use and willingness to use PrEP
Perceptions related to PrEP based on the TPB
Statistical analysis
Results
Socio-demographics, HIV prevention service utilization, sexual behaviors and mental health status
All (n = 580) | Without experience of SDU in the past year (n = 498) | With experience of SDU in the past year (n = 82) | With vs. without experience of SDU in the past year | ||
---|---|---|---|---|---|
% | % | % | OR (95%CI) | AOR (95%CI) | |
Socio-demographic characteristics | |||||
Age group | |||||
18–30 | 56.6 | 57.6 | 50.0 | 1.0 | |
31–40 | 31.6 | 30.5 | 37.8 | 1.43 (0.86, 2.37) | |
> 40 | 11.9 | 11.8 | 12.2 | 1.19 (0.56, 2.50) | – |
Highest educational level attained | |||||
Senior high or below | 15.5 | 14.3 | 23.2 | 1.0 | 1.0 |
College or above | 84.5 | 85.7 | 76.8 | 0.55 (0.31, 0.98)* | 0.36 (0.19, 0.69)** |
Current marital status | |||||
Currently single | 84.0 | 84.9 | 78.0 | 1.0 | |
Married/cohabited with a man | 15.7 | 14.7 | 19.8 | 1.63 (0.91, 2.91)† | |
Married/cohabited with a woman | 0.3 | 0.4 | 0.0 | N.A. | – |
Monthly personal income (HK$) | |||||
< 10,000 | 13.4 | 12.7 | 18.3 | 1.0 | |
10,000-19,999 | 29.1 | 28.1 | 35.4 | 0.87 (0.44, 1.74) | |
20,000-39,999 | 36.7 | 37.8 | 30.5 | 0.56 (0.28, 1.13) | |
40,000 and above | 19.7 | 20.5 | 14.6 | 0.49 (0.22, 1.12)† | |
Refuse to disclose | 1.0 | 1.0 | 1.2 | 0.84 (0.09, 7.73) | – |
Current employment status | |||||
Full-time | 83.6 | 85.1 | 74.4 | 1.0 | 1.0 |
Part-time/unemployed/retired/ students | 16.4 | 14.9 | 25.6 | 1.97 (1.13, 3.43)* | 1.37 (0.74, 2.56) |
Sexual orientation | |||||
Homosexual | 90.7 | 90.4 | 92.7 | 1.0 | |
Bisexual | 8.4 | 8.6 | 7.3 | 0.83 (0.34, 2.01) | |
Heterosexual | 0.9 | 1.0 | 0.0 | N.A. | – |
Channels of recruitment | |||||
Outreach in gay venues | 14.1 | 13.3 | 19.5 | 1.0 | |
Online recruitment | 57.6 | 58.6 | 51.2 | 0.59 (0.31, 1.12) | |
Peer referral | 28.3 | 28.1 | 29.3 | 0.71 (0.35, 1.42) | – |
Service utilization | |||||
HIV testing in the last 12 months | |||||
No | 28.4 | 29.9 | 19.5 | 1.0 | |
Yes | 71.6 | 70.1 | 80.5 | 1.76 (0.99, 3.14)† | – |
Other HIV prevention services in the last 12 months (e.g., condom distribution, peer education, pamphlet and lectures) | |||||
No | 44.7 | 46.8 | 31.7 | 1.0 | 1.0 |
Yes | 55.3 | 53.2 | 68.3 | 1.89 (1.15, 3.11)* | 1.77 (1.03, 3.05)* |
History of sexual transmitted infections | |||||
History of sexually transmitted infections other than HIV | |||||
No | 80.5 | 82.9 | 65.9 | 1.0 | 1.0 |
Yes | 19.5 | 17.1 | 34.1 | 2.52 (1.51, 4.21)*** | 1.72 (0.97, 3.07)† |
Sexual behaviors in the last 12 months | |||||
Had had anal intercourse with regular male sex partners (RP) | |||||
No | 14.7 | 13.5 | 22.0 | 1.0 | 1.0 |
Yes | 85.3 | 86.5 | 78.0 | 0.55 (0.31, 0.99)* | 0.90 (0.46, 1.73) |
Had had anal intercourse with non-regular male sex partners (NRP) | |||||
No | 39.1 | 44.0 | 9.8 | 1.0 | 1.0 |
Yes | 60.9 | 56.0 | 90.2 | 7.26 (3.43, 15.38)*** | 7.75 (2.30, 26.09)** |
Condomless anal intercourse (CAI) with men | |||||
No | 60.5 | 63.7 | 41.5 | 1.0 | 1.0 |
Yes | 39.5 | 36.3 | 58.5 | 2.47 (1.54, 3.98)*** | 2.46 (1.44, 4.21)** |
Multiple male sex partnerships | |||||
No | 30.7 | 34.1 | 9.8 | 1.0 | 1.0 |
Yes | 69.3 | 65.9 | 90.2 | 4.79 (2.26, 10.18)*** | 0.84 (0.25, 2.80) |
Use of pre-exposure prophylaxis (PrEP) | |||||
Currently on PrEP | |||||
No | 96.0 | 97.8 | 85.4 | 1.0 | 1.0 |
Yes | 4.0 | 2.2 | 14.6 | 7.59 (3.23, 17.86)*** | 4.09 (1.56, 10.73)** |
Mental health status | |||||
Depressive symptoms | |||||
No clinical depressive symptoms (CES-D-10 score < 10) | 64.1 | 65.7 | 54.9 | 1.0 | |
Presence of clinical depressive symptoms (CES-D-10 score ≥ 10) | 35.9 | 34.3 | 45.1 | 1.57 (0.98, 2.52)† | – |
Anxiety | |||||
No/mild anxiety (GAD-7 score < 15) | 94.0 | 94.4 | 91.5 | 1.0 | |
Severe anxiety (GAD-7 score ≥ 15) | 6.0 | 5.6 | 8.5 | 1.57 (0.66, 3.72) | – |
Prevalence of SDU in the past year and associated factors
% / Mean (SD) | |
---|---|
Patterns of SDU | (n = 82) |
Types of psychoactive substance used during SDU in past year | |
Ketamine | 1.2 |
Methamphetamine | 31.7 |
Cocaine | 1.2 |
Cannabis | 8.5 |
Ecstasy | 3.7 |
Dormicum / Halcion / Erimin 5 / Hypnotic drugs (non-prescription) | 0.0 |
Heroin | 0.0 |
Cough suppressant (not for curing cough) | 1.2 |
Amyl nitrite | 80.5 |
GHB/GBL | 31.7 |
5-methoxy-N, N-diisopropyltryptamine (Foxy) | 4.9 |
Mephedrone | 0.0 |
Poly-use of psychoactive substances in lifetime | |
No | 69.5 |
Yes | 30.5 |
Time since the first episode of SDU | |
< 1 year | 40.2 |
1–2 years | 15.9 |
3–5 years | 15.9 |
> 5 years | 28.0 |
Frequency of SDU in the past year | |
1 episode/month | 37.8 |
1–2 episodes/month | 29.3 |
≥ 3 episodes/month | 32.9 |
Condomless anal intercourse during SDU in the past year | |
No | 48.8 |
Yes | 51.2 |
Drug cessation/rehabilitation services provided by governmental organizations | |
No | 97.6 |
Yes | 2.4 |
Drug cessation/rehabilitation services provided by non-governmental organizations | |
No | 90.2 |
Yes | 9.8 |
Details of the most recent episode of SDU | |
Number of participants | |
2 | 78.0 |
≥ 3 | 22.0 |
Alcohol consumption | |
No | 85.4 |
Yes | 14.6 |
Use of erectile dysfunction drugs | |
No | 69.5 |
Yes | 30.5 |
Group sex | |
No | 80.5 |
Yes | 19.5 |
Condomless anal intercourse | |
No | 48.8 |
Yes | 51.2 |
Perceptions related to PrEP (among participants with experience of SDU in the past year who were not on PrEP) | (n = 70) |
Willingness to take once-daily oral pill as PrEP in the next six months after being briefed some facts of PrEP | |
No (definitely not/probably not/neutral) | 32.9 |
Yes (probably will/definitely will) | 67.1 |
Willingness to pay (HK$ per month) for using once-daily oral pill as PrEP (among those with willingness to take PrEP in the next six months, n = 56) | |
≤ 300 | 24.2 |
301–500 | 14.3 |
501–1000 | 18.6 |
1000–2000 | 21.4 |
2001–4000 | 17.1 |
4001–6000 | 2.9 |
6001–8000 | 1.4 |
> 8000 | 0.0 |
Perceptions related to PrEP based on the TPB | |
Positive attitudes toward PrEP (% agree) | |
PrEP can reduce your chance of HIV infection during SDU | 81.4 |
PrEP would reduce your worry of HIV infection when having condomless sex during SDU | 64.3 |
PrEP provides you more choice for HIV prevention | 84.3 |
Positive Attitude Scalea | 8.1 (1.3) |
Negative attitudes toward PrEP (% agree) | |
Psychoactive substances that are used during SDU would reduce the protective effect of PrEP | 17.1 |
Psychoactive substances that are used during SDU would aggravate the side-effects of PrEP | 30.0 |
Psychoactive substances that are used during SDU would make you forget to take PrEP | 28.6 |
Daily use of PrEP would cause severe financial burden for you | 80.0 |
You will be stigmatized by medical professionals when you are using PrEP-related services | 37.1 |
Negative Attitude Scaleb | 10.2 (2.2) |
Perceived subjective norm related to PrEP | |
People who are important to you will support you to use PrEP | |
Disagree/neutral | 32.9 |
Agree | 67.1 |
Perceived behavioral control to use PrEP | |
In general, you are confident in taking PrEP every day in the next six months | |
Strongly disagree/disagree/neutral | 35.7 |
Agree/strongly agree | 64.3 |
PrEP uptake and willingness to use daily oral PrEP
Factors associated with willingness to use daily oral PrEP in the next six months among GBMSM with SDU in the past year
Row% | OR (95%CI) | |
---|---|---|
Socio-demographic characteristics | ||
Age group | ||
18–30 | 53.2 | 1.0 |
31–40 | 57.8 | 0.55 (0.19, 1.59) |
> 40 | 77.8 | 1.40 (0.25, 7.93) |
Highest educational level attained | ||
Senior high or below | 83.3 | 1.0 |
College or above | 61.5 | 0.32 (0.08, 1.25)† |
Current marital status | ||
Currently single | 69.0 | 1.0 |
Married/cohabited with a man | 64.3 | 0.81 (0.29, 2.22) |
Monthly personal income (HK$) | ||
< 10,000 | 75.0 | 1.0 |
10,000-19,999 | 74.1 | 0.95 (0.20, 4.55) |
20,000-39,999 | 63.6 | 0.58 (0.12, 2.80) |
40,000 and above | 44.4 | 0.27 (0.04, 1.70) |
Current employment status | ||
Full-time | 67.9 | 1.0 |
Part-time/unemployed/retired/ students | 64.7 | 0.87 (0.27, 2.73) |
Sexual orientation | ||
Homosexual | 66.2 | 1.0 |
Bisexual | 80.0 | 2.05 (0.22, 19.43) |
Channels of recruitment | ||
Outreach in gay venues | 73.3 | 1.0 |
Online recruitment | 68.4 | 0.79 (0.21, 2.99) |
Peer referral | 58.8 | 0.52 (0.12, 2.32) |
Service utilization | ||
HIV testing in the last 12 months | ||
No | 50.0 | 1.0 |
Yes | 72.0 | 2.60 (1.01, 7.18)* |
Other HIV prevention services in the last 12 months (e.g., condom distribution, peer education, pamphlet and lectures) | ||
No | 73.9 | 1.0 |
Yes | 63.8 | 0.62 (0.21, 1.88) |
Drug cessation/rehabilitation services provided by governmental organizations | ||
No | 69.1 | 1.0 |
Yes | 0.0 | N.A. |
Drug cessation/rehabilitation services provided by non-governmental organizations | ||
No | 68.3 | 1.0 |
Yes | 57.1 | 0.62 (0.13, 3.04) |
History of sexual transmitted infections/viral hepatitis | ||
History of other sexually transmitted infections | ||
No | 68.0 | 1.0 |
Yes | 65.0 | 0.87 (0.29, 2.61) |
Sexual behaviors in the last 12 months | ||
Had had anal intercourse with regular male sex partners (RP) | ||
No | 68.8 | 1.0 |
Yes | 66.7 | 0.91 (0.27, 3.02) |
Had had anal intercourse with non-regular male sex partners (NRP) | ||
No | 57.1 | 1.0 |
Yes | 68.3 | 1.61 (0.33, 7.89) |
OR (95%CI) | AOR (95%CI) | |
---|---|---|
Patterns of SDU | ||
Poly-use of psychoactive substances during SDU the past year | ||
No | 1.0 | |
Yes | 2.02 (0.58, 7.01) | – |
Time since the first episode of SDU | ||
< 1 year | 1.0 | |
1–2 years | 1.00 (0.21, 4.77) | |
3–5 years | 1.14 (0.25, 5.33) | |
> 5 years | 0.59 (0.18, 1.96) | – |
Frequency of SDU in the past year | ||
1 episode/month | 1.0 | |
1–2 episodes/month | 0.81 (0.25, 2.67) | |
≥ 3 episodes/month | 1.33 (0.39, 4.58) | – |
Condomless anal intercourse in the past year | ||
No | 1.0 | |
Yes | 0.88 (0.32, 2.40) | – |
Perceptions related to PrEP | ||
Positive Attitude Scale | 2.30 (1.46, 3.62)*** | 2.37 (1.47, 3.82)*** |
Negative Attitude Scale | 1.16 (0.91, 1.47) | – |
People who are important to you will support you to use PrEP | ||
Disagree/neutral | 1.0 | 1.0 |
Agree | 9.14 (2.90, 28.77)*** | 9.67 (2.95, 31.71)*** |
In general, you are confident in taking PrEP every day in the next six months | ||
Strongly disagree/disagree/neutral | 1.0 | 1.0 |
Agree/strongly agree | 20.57 (5.75, 73.65)*** | 19.68 (5.44, 71.26)*** |
Mental health status | ||
Depressive symptoms | ||
No clinical depressive symptoms | 1.0 | |
Presence of clinical depressive symptoms | 0.88 (0.32, 2.40) | – |
Anxiety | ||
No/mild/anxiety | 1.0 | |
Severe anxiety | 0.46 (0.08, 2.45) | – |