Abstract Background Men who have sex with men (MSM) represent a high-incidence population with HIV, while HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are among the most effective interventions to prevent HIV transmission and save lives. Aim This study aims to analyze the awareness, use, and acceptability of HIV PrEP and PEP among MSM to inform optimized implementation strategies for this population. Methods A non-government organization based questionnaire survey was used to collect data from July 2022 to December 2023. A total of 1065 MSM were incorporated into our analysis with the following information: socio-demographics, awareness, use, and acceptability of HIV PrEP and PEP. Binary logistic regression analysis was employed to determine the factors on seeking, use, and acceptability of PrEP and PEP. Outcomes Despite high awareness of PrEP/PEP, actual adoption remained limited among MSM. Results The average age of the participants was 28.48 ± 7.33. About 89.7% of the participants were aware of PrEP and 94.4% were aware of PEP. About 7.9% of the participants have used PrEP and 11.6% have used PEP. About 87.9% of the participants had willingness to use PrEP and 90.2% had willingness to use PEP. The main ways for the participants to get PrEP and PEP were through Internet hospitals, followed by local hospitals, and recommendations from acquaintances. The most concerned factors were preventive effect followed by side effects of PrEP and PEP. Doubts about the preventive effect of PrEP and PEP significantly affect their seeking, use, and acceptability (P .05). Clinical Translation This study provides insights for enhancing the implementation of HIV PrEP and PEP among MSM. Strengths and Limitations This study is the first to depict the situation of awareness, use, and acceptability of HIV PrEP and PEP among MSM in China. Limitations involve social desirability bias and reliance on self-reported diagnosis. Conclusion Accelerating PrEP/PEP scale-up requires enhanced risk perception, expanded service access, and comprehensive sensitization programs.
Zhang et al. (2025) studied this question.