[The confidence affects willingness to use pre-exposure prophylaxis among MSM, based on Path analysis].

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.