Objective To explore the demand for HIV pre-exposure prophylaxis（Pr EP） medication and its influencing factors among men who have sex with men（MSM） in Changsha. Methods At the Changsha MSM population sentinel surveillance station "Hunan Left Bank Rainbow Working Group"

295 MSM who came for testing or Pr EP assessment from November 2019 to June 2020 were selected as survey respondents using non-probability sampling method. Results 54.2% of survey respondents had heard of HIV Pr EP. Univariate analysis revealed statistically significant differences in demand for HIV Pr EP services among survey respondents with different monthly income levels

knowledge of the HIV epidemic in the local MSM population

whether they had experienced risky sexual behaviors such as condom breakage or slippage

and whether they had had same-sex commercial sex in the last 6 months（P<0.05）. After being informed of the uniform standardized content of HIV Pr EP services

30.8% of the respondents considered themselves in need of HIV Pr EP services

and 69.2% considered themselves not in need of HIV Pr EP services. Among those who thought they needed HIV Pr EP services

38.4% chose "good protective effect of HIV Pr EP drugs"

21.6% chose "high risk of pre-exposure to HIV"

and 10.4% chose the reason "unknown HIV infection status of sexual partners". Among the respondents who did not think they needed HIV Pr EP services

34.3% chose "use condom every time they have sex"

20.6%chose "worry about the side effects of the drug"

and 20.0% chose "high cost". Conclusion The awareness rate of Pr EP among MSM in Changsha is high

but the willingness to use it is low

and there is a separation between awareness and practice.