文章摘要
罗涛,古丽斯亚·海力力,陈珍,妥小青,蔡爱杰,张昭,戴江红.基于路径分析探讨MSM暴露前预防用药自信度对用药意愿影响[J].中华流行病学杂志,2019,40(10):1279-1284
基于路径分析探讨MSM暴露前预防用药自信度对用药意愿影响
The confidence affects willingness to use pre-exposure prophylaxis among MSM, based on Path analysis
收稿日期:2019-01-11  出版日期:2019-10-18
DOI:10.3760/cma.j.issn.0254-6450.2019.10.020
中文关键词: 男男性行为人群;暴露前预防用药;用药自信度;用药意愿;路径分析
英文关键词: Men who have sex with men;Pre-exposure prophylaxis;Confidence;Willingness;Path analysis
基金项目:国家自然科学基金(81560539);国家科技重大专项(2012ZX10001-007)
作者单位E-mail
罗涛 新疆医科大学公共卫生学院流行病学与卫生统计学教研室, 乌鲁木齐 830011  
古丽斯亚·海力力 新疆医科大学公共卫生学院流行病学与卫生统计学教研室, 乌鲁木齐 830011  
陈珍 新疆医科大学公共卫生学院流行病学与卫生统计学教研室, 乌鲁木齐 830011  
妥小青 新疆医科大学公共卫生学院流行病学与卫生统计学教研室, 乌鲁木齐 830011  
蔡爱杰 新疆医科大学公共卫生学院流行病学与卫生统计学教研室, 乌鲁木齐 830011  
张昭 新疆医科大学公共卫生学院流行病学与卫生统计学教研室, 乌鲁木齐 830011  
戴江红 新疆医科大学公共卫生学院流行病学与卫生统计学教研室, 乌鲁木齐 830011 epi102@sina.com 
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中文摘要:
      目的 利用结构方程模型(SEM)取向的路径分析模型分析MSM暴露前预防(PrEP)用药自信度对用药意愿的影响。方法 采用滚雪球法在乌鲁木齐市招募MSM 550人,并进行问卷调查。根据专业知识及用药自信度、用药意愿多因素分析结果,使用SEM方法构建路径分析模型。结果 完成调查MSM 513人。修正后路径分析方程模型拟合良好,修正后拟合指数GFI=0.993、RMSEA<0.001、AGFI=0.984。用药自信度对用药意愿存在直接影响;性伴对PrEP的态度、用药受性伴影响程度及积极情绪不仅对用药意愿有直接影响,并通过影响用药自信度对用药意愿存在间接效应;性行为的角色、认为艾滋病严重程度、艾滋病预防行为对PrEP用药意愿存在直接效应;人群艾滋病感染比例对用药意愿无直接效应,但通过影响用药自信度而存在间接效应。结论 MSM暴露前预防用药自信度对用药意愿存在影响,可对MSM开展针对性干预措施,提高MSMPrEP用药自信度及用药意愿;相对于传统多因素回归分析,利用SEM取向的路径分析能够更好的揭示自变量与因变量之间的中介效应。
英文摘要:
      Objective To analyze the influence of the confidence to pre-exposure prophylaxis (PrEP) on the willingness to use PrEP in men who have sex with men (MSM) by using the path analysis model based on structural equation model approach. Methods A total of 550 MSM were recruited in Urumqi by snowball method and a questionnaire survey was conducted among them. According to the professional knowledge and analysis results of the confidence and willingness to use PrEP, structural equation model (SEM) analysis method was used to construct a path analysis model. Results A total of 513 MSM participated in the survey. The modified path equation model was well fitted, with the modified fitting index as:GFI=0.993, RMSEA<0.001, and AGFI=0.984. The confidence to PrEP had direct influence on the willingness; the degree of influence from sex partners, the attitude of sex partner to PrEP and the positive emotions not only had direct effects on willingness of PrEP use, but also had indirect effects on willingness of PrEP use by affecting the confidence to it; the role in sexual behavior, AIDS severity, HIV prevention behavior had direct effects on willingness of PrEP use. The proportion of HIV infection in the population had no direct effects on willingness of PrEP use, but had indirect effects on willingness of PrEP use by affecting the confidence to it. Conclusions The confidence to PrEP had influence on willingness of PrEP use in MSM, therefore targeted activities can be conducted to improve the confidence and willingness of MSM in taking the PrEP and reducing the risk of HIV infection in MSM. Compared with the traditional multiple regression analysis, the path analysis using the structural equation model could better reveal the mediating effect between the independent variables and dependent variables.
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