Assessing the HIV Prevention Needs of Young Gay and Bisexual Men in the PrEP Era: An Analysis of Trends in Australian Behavioural Surveillance, 2014–2018

This study assessed the perceived importance of five health issues for gay and bisexual men ( N = 660) using time-space sampling in gay bars/clubs and bathhouses in New York City: “HIV & STDs,” “Drugs & Alcohol,” “Body Image,” “Mental Health,” and “Smoking.” This study compared ratings based on demographic differences, recent substance use, recent sexual risk behavior, and whether or not participants owned a smart device (e.g., “smart” phone, iPad, iPod touch). Contrary to research indicating that gay and bisexual men may be experiencing HIV prevention fatigue, this study identified that HIV and STIs were perceived as most important. Drugs and alcohol and mental health were also rated high, suggesting that providers may be well served to include mental health and drugs and alcohol as part of their comprehensive approach to HIV prevention. A majority of participants (72%) owned a smart device. Smart device owners rated health issues similarly to those who did not, suggesting that such devices may be a useful platform to reach gay and bisexual men for health education and prevention.

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Measuring and understanding the attitudes of Australian gay and bisexual men towards biomedical HIV prevention using cross-sectional data and factor analyses

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053375 ◽

2017 ◽

Vol 94 (4) ◽

pp. 309-314 ◽

Cited By ~ 5

Author(s):

Anna L Wilkinson ◽

Bridget L Draper ◽

Alisa E Pedrana ◽

Jason Asselin ◽

Martin Holt ◽

...

Keyword(s):

Hiv Prevention ◽

Community Support ◽

Gay And Bisexual Men ◽

Transmission Risk ◽

Treatment As Prevention ◽

Bisexual Men ◽

Cross Sectional ◽

Biomedical Hiv Prevention ◽

Biomedical Prevention ◽

And Bisexual

IntroductionContemporary responses to HIV embrace biomedical prevention, particularly treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP). However, large-scale implementation of biomedical prevention should be ideally preceded by assessments of their community acceptability. We aimed to understand contemporary attitudes of gay and bisexual men (GBM) in Australia towards biomedical-based HIV prevention and propose a framework for their measurement and ongoing monitoring.MethodsA cross-sectional, online survey of GBM ≥18 years has been conducted annually in Victoria, Australia, since 2008. In 2016, 35 attitudinal items on biomedical HIV prevention were added. Items were scored on five-point Likert scales. We used principal factor analysis to identify key constructs related to GBM’s attitudes to biomedical HIV prevention and use these to characterise levels of support for TasP and PrEP.ResultsA total of 462 HIV-negative or HIV-status-unknown men, not using PrEP, provided valid responses for all 35 attitudinal items. We extracted four distinct and interpretable factors we named: ‘Confidence in PrEP’, ‘Judicious approach to PrEP’, ‘Treatment as prevention optimism’ and ‘Support for early treatment’. High levels of agreement were seen across PrEP-related items; 77.9% of men agreed that PrEP prevented HIV acquisition and 83.6% of men agreed that users were protecting themselves. However, the agreement levels for HIV TasP items were considerably lower, with <20% of men agreeing treatment (undetectable viral load) reduced HIV transmission risk.ConclusionsBetter understanding of community attitudes is crucial for shaping policy and informing initiatives that aim to improve knowledge, acceptance and uptake of biomedical prevention. Our analyses suggest confidence in, acceptability of and community support for PrEP among GBM. However, strategies to address scepticism towards HIV treatment when used for prevention may be needed to optimise combination biomedical HIV prevention.

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