Objective To assess the awareness and willingness to use post-exposure prophylaxis (PEP) and influencing factors among men who have sex with men (MSM) in Heilongjiang province for further promotion and implementation of PEP programs among MSM.

Methods Using snowball sampling, we recruited 404 MSM residing in Harbin city who were ≥18 years old, HIV negative, or unaware of their HIV status. Face-to-face interviews were conducted among the MSM from September to November 2021 to collect relevant information by taking a self-developed PEP questionnaire based on that used in the national sentinel surveillance program. Chi-squared tests, univariate and multivariate unconditional logistic regression analyses were used to analyze factors influencing MSM's willingness to accept PEP.

Results Of the MSM surveyed with a median age of 36 years, 68.812% reported the willingness to use PEP. Univariate analysis revealed that marital status, education, personal monthly income, sexual orientation, primary venue for finding male partners, HIV knowledge, sexual role during anal intercourse, number of male sex partners in the least 6 months, frequency of condom use during anal sex with men in the least 6 months, number of HIV tests, PEP awareness, and the maximum acceptable price of PEP were significant factors associating with willingness to accept PEP (all P<0.050). Multivariate unconditional logistic regression analysis showed that education level (odds ratio OR=5.500, 95% confidence interval 95%CI: 2.174–13.911), number of male sex partners (OR=21.708, 95%CI: 6.258–75.305), frequency of condom use during anal sex with men in the least 6 months (OR=9.301, 95%CI: 2.711–31.904), and number of HIV tests (OR=3.218, 95%CI: 1.500–6.904) were the main factors influencing willingness to use PEP.

Conclusions The willingness to accept PEP is relatively high among MSM in Heilongjiang province, suggesting that PEP should be promoted among local MSM to reduce HIV infection.