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HIV non-occupational postexposure prophylaxis (nPEP) usage among five key populations in China
  1. Haochu Li1,
  2. Ran Wei2,
  3. Eduardo Piqueiras3,
  4. Eric P F Chow4,5,6,
  5. Kedi Jiao1,
  6. Taylor Lewis7,
  7. Wei Ma1
  1. 1Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
  2. 2Shandong Provincial Chest Hospital, Jinan, Shandong, China
  3. 3Department of Public Health, Wayne State University, Detroit, Michigan, USA
  4. 4Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
  5. 5Central Clinical School, Monash University, Melbourne, Victoria, Australia
  6. 6Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  7. 7Research Triangle Institute (RTI) International, Washington, DC, USA
  1. Correspondence to Professor Wei Ma, Dept. of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; weima{at}


Objectives To examine the feasibility of non-occupational postexposure prophylaxis (nPEP) as a national strategy for HIV prevention in China, we investigated nPEP usage and related sociodemographic and behavioural factors among five key populations at high risk of contracting HIV.

Methods We conducted a cross-sectional study among five key populations from November 2018 to September 2019 in China using convenience sampling to recruit participants aged ≥18 years, self-reporting HIV status as either negative or unknown and providing written informed consent. Univariable and multivariable logistic regression models were fitted.

Results Our analysis included data from 2022 participants with a mean age of 35 years (SD=11.62). Only 57 (2.82%) participants had ever used nPEP. Sociodemographic and behavioural factors related to nPEP usage included populations (p<0.0001), age (p<0.05), education (p<0.05), nPEP knowledge (p<0.01), receiving conventional HIV prevention services (p<0.05) and HIV testing (p<0.05). A significant percentage (26%) of nPEP users used nPEP medication more than once. Challenges and concerns, such as multiple use of nPEP and syndemic conditions, were emerging.

Conclusions Key populations in China had low nPEP usage rates. Female sex workers, people who use drugs, older and illiterate individuals with poor nPEP knowledge, not using HIV prevention services or never tested for HIV should be emphasised. Implementing nPEP services would be an important way to access high-risk individuals for intensive and tailored HIV prevention and intervention. Challenges of providing nPEP services and future study foci are highlighted.

  • HIV
  • post-exposure prophylaxis
  • China

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  • Handling editor Joseph D Tucker

  • Twitter @EricPFChow

  • HL and RW contributed equally.

  • Correction notice The article has been corrected since it is published. The affiliation 5 has been updated.

    Also, the provenance and peer review statement has been included.

  • Contributors HL, RW and WM contributed to the conception and design of the study. HL and EP wrote the first draft of the manuscript. WM provided oversight for data collection. RW, HL and KJ assisted in the data collection and management. EP, HL, RW and KJ performed the literature search. HL, EPFC and TL involved in data analyses and interpretation. HL and KJ made the figure and tables. EPFC, TL and WM provided substantial comments to the manuscript. HL, EP and EPFC revising the manuscript critically for important intellectual content. All authors read and approved the final manuscript.

  • Funding This work was supported by the National Key Research and Development Program (2017YFE0103800), the National Science and Technology Major Project (2018Z×10721102–003004) in China, and the i Guardian Platform of the People’s Medical Publishing House. EPFC is supported by an Australian National Health and Medical Research Council Emerging Leadership Investigator Grant (GNT1172873).

  • Disclaimer The listed grant funders played no role in any step of this study.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.