scholarly journals Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese men who have sex with men

2020 ◽  
Author(s):  
Xiaoyou Su ◽  
Mingyu Si ◽  
Li Yan ◽  
Yu Jiang ◽  
Yuanli Liu ◽  
...  

Abstract BackgroundDespite strengthened efforts on HIV prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China. Pre-exposure prophylaxis (PrEP), a highly effective HIV prevention tool, has recently been included in China’s Action Plan of HIV Prevention and Control. To inform future PrEP implementation, this study aims to identify the barriers and facilitators of PrEP intention among MSM in China. MethodsIn 2018, a cross-sectional survey was conducted among 300 MSM in Nanjing, Jiangsu Province. Questions on demographics, sexual behavior (including a 7-item high-risk behavior index), PrEP use intention, PrEP-related awareness and accessibility, and a 7-item public HIV stigma scale were included in the questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP intention. ResultsOverall, 44.67% had more than 2 male sexual partners and 5.56% had HIV-positive sexual partners. Just 57.00% had heard of PrEP and only 4 (1.33%) participants had used PrEP. However, 75.34% expressed a willingness to use oral PrEP if its efficacy was assured. Beliefs that ‘PrEP can prevent HIV if taken as prescribed’ (aOR=4.84, p<0.001), and ‘PrEP can be scaled up in the community’ (aOR=3.24, p<0.001), were positively associated with oral PrEP intention. Concerns of side effects were negatively associated with oral PrEP intention (aOR=0.32, p =0.006). Respectively 77.00% of the participants would choose injectable or implanted PrEP instead of oral PrEP. One of the PrEP stigma items, ‘Not certain if doctors can prescribe PrEP if I go to the clinic’ was positively associated with the intention to use injectable or implanted PrEP (aOR=3.03). Individuals who had heard of PrEP (aOR=2.74) and believed ‘PrEP can prevent HIV if taken as prescribed’ (aOR=2.65) were also positively related to the intention to use injectable or implanted PrEP. The most common concerns regarding PrEP use were efficacy (44.67%) and side effects (38.67%). The most common reasons for using injectable and implanted PrEP were adherence (81.94% and 77.86%, respectively) and privacy concerns (56.48% and 55.00%, respectively). Affordable price and coverage of health insurance are the driving factors for using PrEP. ConclusionsGiven the relatively low awareness of PrEP-related information in China, interventions on awareness and knowledge targeting high risk individuals and communities are needed. Furthermore, additional alternatives to prevent HIV, such as long-acting injectable or implanted PrEP, should be investigated to reduce the risk of HIV infection in at-risk MSM. Particularly, it is necessary to develop a more supportive social environment for MSM when implementing PrEP programs that are approved by China’s FDA.

2019 ◽  
Author(s):  
Xiaoyou Su ◽  
Mingyu Si ◽  
Li Yan ◽  
Yu Jiang ◽  
Yuanli Liu ◽  
...  

Abstract Background Despite strengthened efforts on HIV prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China. Pre-exposure prophylaxis (PrEP), a highly effective HIV prevention tool, has recently been included in the China’s Action Plan of HIV Prevention and Control. To inform future PrEP implementation, this study is to identify barriers and facilitators of PrEP intention among MSM in China. Methods A cross-sectional survey was conducted among 300 MSM in Nanjing, Jiangsu Province in 2018. Demographic information, a 7-item high-risk behavior index, PrEP use intention, PrEP-related awareness and accessibility, and a 7-item public HIV stigma scale were included in the questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP intention. Results Overall, just 55.7% of participants had ever heard of PrEP, while 75.3% expressed willingness to use PrEP if efficacy was assured. Beliefs that ‘PrEP can prevent HIV if taken as prescribed (aOR=4.84, p<0.001), and ‘PrEP can be scaled up in the community’(aOR=3.24, p<0.001), were positively associated with PrEP intention. Concerns of side effects were negatively associated with PrEP intention (aOR=0.32, p =0.006). Conclusions Given the relatively low awareness of PrEP-related information in China, interventions on awareness and knowledge targeting high risk individuals and community are needed to scale up of oral PrEP implementation once approved by China FDA. Keywords MSM; HIV; PrEP; Intention


2019 ◽  
Author(s):  
Denis Nash ◽  
Matthew Stief ◽  
Caitlin MacCrate ◽  
Chloe Mirzayi ◽  
Viraj V Patel ◽  
...  

BACKGROUND Gay, bisexual, and other men who have sex with men continue to bear a large burden of the HIV epidemic in the United States and are among the only populations with increasing incidence in recent years. OBJECTIVE The Together 5000 (T5K) Study aimed to enroll a US-based, racially diverse sample of HIV-negative men, transmen, and transwomen who are not on pre-exposure prophylaxis (PrEP) into an observational cohort to inform the design, implementation, scale-up, and evaluation of HIV prevention programs. METHODS We used internet-based strategies to enroll a large, racially diverse national sample of HIV-negative men, transmen, and transwomen aged 16 to 49 years at high risk of HIV acquisition via sexual networking apps. Study participants are contacted every 6 months (in between annual surveys) for a brief survey on HIV testing, HIV diagnosis, and PrEP use (ie, attempts to access, PrEP initiation, and PrEP discontinuation). Participants complete annual self-administered at-home HIV testing and Web-based surveys. Using baseline serologic data and self-reported HIV testing history, we reconstructed a cohort of persons who were HIV negative at 12 months before baseline to estimate HIV incidence leading up to cohort enrollment. RESULTS The study sample included 8777 participants from all 50 US states, Puerto Rico, and Guam; 50.91% (4468/8777) were persons of color and 25.30% (2221/8777) were young individuals aged 16 to 24 years. Per eligibility criteria, all T5K participants reported having sex with >2 male partners in the 90 days before enrollment, self-reported not having been diagnosed with HIV, and were not actively taking PrEP. In addition, 79.39% (6968/8777) reported >2 insertive condomless anal sex (CAS) acts, 61.02% (5356/8777) reported >1 receptive CAS acts in the past 90 days. Furthermore, most (7525/8777, 85.74%) reported never having taken PrEP. In total, 70.25% (6166/8777) were sent a self-administered at-home HIV test kit and 82.29% (5074/6166) of those sent a kit returned a sample for testing. The HIV incidence rate during the 12-month period leading up to enrollment was estimated to be 2.41 (95% CI 2.02-2.90) per 100 person-years. CONCLUSIONS A large, national, and racially diverse fully Web-based cohort of HIV-negative men, transmen, and transwomen at high risk for HIV seroconversion has successfully been recruited into longitudinal follow-up. This cohort is at high risk for HIV acquisition and can provide important insights related to the real-world uptake, impact, and equity of HIV prevention interventions in the United States. Participants can be invited to participate in trials aimed at testing strategies to improve the uptake of and engagement in these interventions. INTERNATIONAL REGISTERED REPORT RR1-10.2196/13715


Medicine ◽  
2019 ◽  
Vol 98 (50) ◽  
pp. e18232
Author(s):  
Adiba Hassan ◽  
Joel O. Wertheim ◽  
Jill S. Blumenthal ◽  
Eric Ellorin ◽  
Michael P. Dube ◽  
...  

2016 ◽  
Vol 21 (5) ◽  
pp. 1336-1349 ◽  
Author(s):  
George J. Greene ◽  
Greg Swann ◽  
Angela J. Fought ◽  
Alex Carballo-Diéguez ◽  
Thomas J. Hope ◽  
...  

Author(s):  
Liping Peng ◽  
Wangnan Cao ◽  
Jing Gu ◽  
Chun Hao ◽  
Jibin Li ◽  
...  

This study aimed to investigate the levels of willingness to use pre-exposure prophylaxis (PrEP) and intention to adhere to PrEP and to further explore factors associated with PrEP uptake among men who have sex with men (MSM) in China. A total of 524 MSM were recruited from Chengdu, China. Half of the participants had heard of PrEP, and the awareness rate varied from 33.8%, 30.7%, and 7.1% for daily oral PrEP, on-demand PrEP, and long-acting injectable PrEP (LAI-PrEP), respectively. The overall willingness to use any type of PrEP in the next six months was 84.9% if PrEP is effective and provided for free. Participants were less likely to say that they would use PrEP if they used a condom consistently with their regular partners. However, participants were more likely to say that they would use PrEP if they had casual partners in the past month and had higher HIV prevention literacy. The majority of participants intended to adhere to PrEP prescription. More than forty percent (43.1%) of the participants reported that they might reduce condom use if they took PrEP. We found that the overall willingness to use PrEP was high among MSM living in China, but willingness varied across the different types of PrEP.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haochu Li ◽  
Ran Wei ◽  
Jason J. Ong ◽  
Eunsook Kim ◽  
Traci L. Weinstein ◽  
...  

Abstract Background In China, non-occupational post-exposure prophylaxis (nPEP) is not a conventional service yet and nPEP related studies are very few. Recently, China’s 13th Five Year Action Plan for HIV/AIDS Containment and Prevention examines the feasibility of including nPEP as one of the national strategies for HIV prevention. However, there is a concern that nPEP use might exacerbate high-risk sexual activities. In order to facilitate a research-based policy making of routinizing nPEP services, the current study examined potential effects of nPEP use on condom use and number of sexual partners among Chinese men who have sex with men (MSM) . Methods A cross-sectional survey was conducted in two cities of China in November and December 2018. Descriptive analyses of participants’ sociodemographic and behavioral characteristics were conducted using SPSS 24.0. Mplus 7.4 was used to conduct confirmatory factor analysis and structural equation modeling. Results The sample included 419 Chinese MSM with a mean age of 28.04 (SD = 9.71). Participants reported more positive anticipation of their own behaviors than other MSM’s behaviors regarding condom use and number of sexual partners if nPEP were to be routinized in China. About 60% of participants reported discrepancies between anticipated individual and population behaviors as a potential result of routinization of nPEP services. Anticipated individual behavioral change was positively related to age and duration of residence in the current city, and negatively related to education. Anticipated population behavioral change was positively related to age. Anticipated behavioral discrepancy was positively related to being ethnic minority and never married. Conclusions These findings identify a high-risk subgroup of MSM, who reported they would use condoms less and/or have more sexual partners when nPEP becomes available. This subgroup of MSM might benefit from targeted health interventions. Moreover, there is a clear discrepancy between anticipated individual and population behavioral changes regarding future routinization of nPEP services, suggesting incorporating nPEP services as a means of community development for MSM.


10.2196/13715 ◽  
2019 ◽  
Vol 8 (9) ◽  
pp. e13715 ◽  
Author(s):  
Denis Nash ◽  
Matthew Stief ◽  
Caitlin MacCrate ◽  
Chloe Mirzayi ◽  
Viraj V Patel ◽  
...  

Background Gay, bisexual, and other men who have sex with men continue to bear a large burden of the HIV epidemic in the United States and are among the only populations with increasing incidence in recent years. Objective The Together 5000 (T5K) Study aimed to enroll a US-based, racially diverse sample of HIV-negative men, transmen, and transwomen who are not on pre-exposure prophylaxis (PrEP) into an observational cohort to inform the design, implementation, scale-up, and evaluation of HIV prevention programs. Methods We used internet-based strategies to enroll a large, racially diverse national sample of HIV-negative men, transmen, and transwomen aged 16 to 49 years at high risk of HIV acquisition via sexual networking apps. Study participants are contacted every 6 months (in between annual surveys) for a brief survey on HIV testing, HIV diagnosis, and PrEP use (ie, attempts to access, PrEP initiation, and PrEP discontinuation). Participants complete annual self-administered at-home HIV testing and Web-based surveys. Using baseline serologic data and self-reported HIV testing history, we reconstructed a cohort of persons who were HIV negative at 12 months before baseline to estimate HIV incidence leading up to cohort enrollment. Results The study sample included 8777 participants from all 50 US states, Puerto Rico, and Guam; 50.91% (4468/8777) were persons of color and 25.30% (2221/8777) were young individuals aged 16 to 24 years. Per eligibility criteria, all T5K participants reported having sex with >2 male partners in the 90 days before enrollment, self-reported not having been diagnosed with HIV, and were not actively taking PrEP. In addition, 79.39% (6968/8777) reported >2 insertive condomless anal sex (CAS) acts, 61.02% (5356/8777) reported >1 receptive CAS acts in the past 90 days. Furthermore, most (7525/8777, 85.74%) reported never having taken PrEP. In total, 70.25% (6166/8777) were sent a self-administered at-home HIV test kit and 82.29% (5074/6166) of those sent a kit returned a sample for testing. The HIV incidence rate during the 12-month period leading up to enrollment was estimated to be 2.41 (95% CI 2.02-2.90) per 100 person-years. Conclusions A large, national, and racially diverse fully Web-based cohort of HIV-negative men, transmen, and transwomen at high risk for HIV seroconversion has successfully been recruited into longitudinal follow-up. This cohort is at high risk for HIV acquisition and can provide important insights related to the real-world uptake, impact, and equity of HIV prevention interventions in the United States. Participants can be invited to participate in trials aimed at testing strategies to improve the uptake of and engagement in these interventions. International Registered Report Identifier (IRRID) RR1-10.2196/13715


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