scholarly journals Factors associated with willingness to use Pre-exposure prophylaxis in Brazil, Mexico and Peru: an online survey among men who have sex with men (Preprint)

2019 ◽  
Author(s):  
Thiago Silva Torres ◽  
Kelika Konda ◽  
E. Hamid Vega-Ramirez ◽  
Oliver Antonio Elorreaga Reyes ◽  
Dulce Diaz-Sosa ◽  
...  

BACKGROUND HIV epidemics disproportionally affect key populations including men who have sex with men (MSM). HIV prevalence among MSM varies from 17% in Brazil and Mexico to 13% in Peru, while it is below 0.5% for the general population. Pre-exposure prophylaxis (PrEP) with daily oral emtricitabine/tenofovir is being implemented in the context of combination HIV prevention. Reports on PrEP awareness, willingness to use, and acceptability among MSM have started to emerge over the last few years. Previously reported factors associated with willingness to use PrEP include: awareness, low cost, higher sexual risk behavior, prior sexually transmitted infection, and unwillingness to use condoms. OBJECTIVE This study aims to evaluate the factors associated with willingness to use daily oral PrEP among MSM in three Latin American, middle-income countries (Brazil, Mexico and Peru). METHODS This online cross-sectional survey was advertised in two gay social network apps (Grindr and Hornet) used by MSM to find sex partners and on Facebook during two months in 2018. Inclusion criteria were ≥18 years of age, cisgender men, and HIV-negative by self-report. Eligible individuals answered questions on: demographics, behavior, and PrEP (awareness, willingness to use, barriers and facilitators). Multivariable logistic regression modeling was performed to assess the factors associated with willingness to use daily oral PrEP in each country. RESULTS From a total sample of 43,687 individuals, 19,457 (45%) MSM were eligible and completed the online survey (Brazil: 58%, Mexico: 31%, Peru: 11%); median age was 28 years (IQR: 24-34), almost half lived in large urban cities and 89% self-defined as homosexual. Most of the participants were recruited on Grindr (69%). Almost 20% had never tested for HIV and condomless receptive anal sex was reported by 46% in the previous 6 months. A total of 13,110 (67%) would be eligible for PrEP (adapted from WHO risk criteria), but only 10% of participants had high HIV risk perception. PrEP awareness was reported by 65%, this was lower in Peru (46%). Overall, willingness to use PrEP was reported by 64%, highest in Mexico (70%) and lowest in Peru (58%). In multivariate regression models adjusted for age, schooling, and income: in each country willingness to use PrEP was positively associated with PrEP awareness and PrEP facilitators (e.g. free PrEP and HIV testing), and negatively associated with behavioral (e.g., concerned by daily pill regimen) and belief barriers (e.g., sex partners may expect condomless anal sex). CONCLUSIONS In this first cross-country online survey in Latin America, willingness to use PrEP was found to be high and directly related to PrEP awareness. Interventions to increase awareness and PrEP knowledge about safety and efficacy are crucial to increase PrEP demand. This study provides important information to support the implementation of PrEP in Brazil, Mexico and Peru.

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.


Author(s):  
Bullinger ◽  
Reyniers ◽  
Vuylsteke ◽  
Laga ◽  
Nöstlinger

Men who have sex with men (MSM) are at high risk for acquiring HIV in Belgium. This study explores MSMs’ hypothetical willingness to use pre-exposure prophylaxis (PrEP), assesses it against formal PrEP eligibility criteria, and identifies factors associated with incongruence between eligibility and willingness. We used data from an online survey of n = 1444 self-reported HIV-negative MSM. Participants were recruited through social media of MSM organizations and dating apps. Univariate analysis described PrEP willingness and eligibility; bivariate analyses examined how specific co-variates (socio-demographic, knowledge-related, and attitudinal and behavioral factors) were associated with eligibility and willingness. About 44% were eligible for PrEP and about 70% were willing to use it. Those who were eligible were significantly more likely be willing to take PrEP (p < 0.001). Two incongruent groups emerged: 16% of eligible participants were unwilling and 58% of ineligible participants were willing to use PrEP. Factors associated with this incongruence were sexual risk behavior, HIV risk perception, partner status, PrEP knowledge, and attitudinal factors. Because the two groups differ in terms of profiles, it is important to tailor HIV prevention and sexual health promotion to their needs. Among those at risk but not willing to take PrEP, misconceptions about PrEP, and adequate risk perception should be addressed.


Author(s):  
Gianluca Voglino ◽  
Maria Rosaria Gualano ◽  
Stefano Rousset ◽  
Pietro Forghieri ◽  
Isabella Fraire ◽  
...  

Background: Pre-exposure prophylaxis (PrEP) is suitable for high human immunodeficiency virus (HIV)-infection risk people, foremost among whom are males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. No previous study has assessed this issue; Methods: An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour and habits, HIV/acquired immune deficiency syndrome (AIDS) knowledge and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify factors associated with PrEP knowledge; Results: A total of 196 MSM participated in this survey. Overall data showed that 87.2% of participants knew what PrEP is, but only 7.5% have ever used it. The main reason for not using PrEP was the cost of the therapy (26.9%). The principal source of PrEP information was the Internet (68.4%). Being regularly tested for HIV was significantly associated with PrEP knowledge (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06–9.29); Conclusions: Knowledge regarding PrEP was well established, but PrEP use was not equally widespread. It is necessary to improve research on PrEP usage in order to PrEP access to be granted.


2019 ◽  
Vol 30 (6) ◽  
pp. 542-549 ◽  
Author(s):  
Alberto Edeza ◽  
Omar Galarraga ◽  
David Novak ◽  
Kenneth Mayer ◽  
Joshua Rosenberger ◽  
...  

In Latin America, men who have sex with men (MSM) remain disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool and has been FDA approved in the United States since 2012, but no Latin American state, with the recent exception of Brazil, has implemented PrEP guidelines. We carried out a multinational online survey of MSM in Latin America (n = 22698) in 2012 to assess whether MSM at highest risk of HIV acquisition (i.e., those engaging in condomless anal sex [CAS; n = 2606] and transactional sex [n = 1488]) had higher levels of awareness of PrEP, PrEP use and interest in participating in a PrEP trial. After adjusting for demographic and psychosocial characteristics including depressive symptoms, hazardous alcohol use, childhood sexual abuse, and sexual compulsivity, transactional sex and CAS were associated with increased PrEP awareness (aOR = 1.29, 95% CI: 1.05–1.59, p < .001 and aOR = 1.22, 95% CI: 1.11–1.34, p < .001, respectively) and PrEP trial interest (aOR = 1.45, 95% CI: 1.25–1.71, p < .001 and aOR = 1.74, 95% CI: 1.57–1.95, p < .001, respectively). Findings demonstrate substantial awareness of and interest in PrEP among MSM with behavioral risk factors for HIV in Latin America, suggesting that this region is primed for PrEP implementation, which has been slow.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
G Voglino ◽  
MR Gualano ◽  
S Rousset ◽  
F Bert ◽  
R Siliquini ◽  
...  

Abstract Background Pre-exposure prophylaxis (PrEP) is suitable for human immunodeficiency virus (HIV)high-infection-risk people, foremost amongst males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. Methods An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour, knowledge on HIV and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify possible associations with PrEP knowledge. Results A total of 196 MSM completed the survey. Overall data showed very good HIV and safe sexual behaviour knowledge (94.4% of correct answers). Nevertheless, our sample rarely used PrEP because of existing barriers: high therapy price (26.9%)and fear of side effects (23.8%). Only 10.3% of partecipants were informed on HIV and PReP by institutional channels, even less (7.5%) from specialized physicians and general practitioners. The most significant association with PrEP knowledge was having regular HIV-tests (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06-9.29); Conclusions PreP's Knowledge was well established, but PrEP use was not widespread. It is necessary to improve communication on PrEP and to lower existing barriers in order to grant access to PrEP access. Key messages Barriers to access PrEP have to be lowered. Healthcare personnel has to be involved in PrEP's benefits communication.


2021 ◽  
Author(s):  
Bashir Ssuna ◽  
Anne Katahoire ◽  
Mari Armstrong-Hough ◽  
Dennis Kalibbala ◽  
Joan N Kalyango ◽  
...  

Abstract Background: The World Health Organization (WHO) recommends the use of pre-exposure prophylaxis (PrEP) in key populations at elevated risk for exposure to HIV. If used effectively, PrEP can reduce annual HIV incidence to below 0.05%. However, PrEP is not acceptable among all communities that might benefit from it. There is, therefore, a need to understand perceptions of PrEP and factors associated with willingness to use PrEP among key populations at risk of HIV, such as members of communities with exceptionally high HIV prevalence. Objective: To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV. Methods: We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP. Key results: We enrolled 283 participants with a mean age of 31±8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6%, 95%CI 75.5-85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31-3.02, P= 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03-1.24, P=0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39-2.81, P<0.001). In focus group discussions, participants described pill burden, side-effects, drug safety, and accessibility as potential barriers to PrEP use. Conclusions and recommendations: Oral PrEP was widely acceptable among members of fishing communities in peri-urban Kampala. Programs for scaling-up PrEP for fisherfolk should merge HIV testing services with sensitization about PrEP and also address issues of access to drugs.


2021 ◽  
Author(s):  
Yuansheng Fu ◽  
Akililu Alemu Ashuro ◽  
Xianxiang Feng ◽  
Ting Wang ◽  
Sichen Zhang ◽  
...  

Abstract Background: HIV pre-exposure prophylaxis (PrEP) is a key component of HIV combination prevention strategies, which has the potential to decrease the incidence of HIV in men who have sex with men (MSM). This study aimed to evaluate the levels of PrEP acceptability and explore the factors associated with willingness to use PrEP among MSM in Liuzhou, China.Methods: Between November 2017 and May 2019, a cross-sectional survey was conducted among 829 MSM. The study participant were recruited through nonprobability sampling method. Participants’ demographics, HIV/AIDS knowledge, sexual behaviors, drug use and HIV test history were collected. Multivariate logistic regression was performed to identify factors associated with willingness to use PrEP.Results: A total of 829 MSM completed the survey, and 30.28%(95%CI: 27.3-33.4) were willing to use PrEP. In multivariate logistic regression, factors associated with a higher willingness to use PrEP include, being Zhuang or Han ethnic origin, recruited through peer introduction or gay venues, pursing higher education level, previous HIV testing and having oral sex with a man. However, had a casual sex in the past six months were associated with lower willingness to use PrEP.Conclusions: MSM in Liuzhou reported a relatively low level of willingness to use PrEP. The results indicate the need for effective education, targeted intervention, and define implementation strategies to promote PrEP acceptance among MSM.


10.2196/15504 ◽  
2019 ◽  
Vol 5 (3) ◽  
pp. e15504 ◽  
Author(s):  
Thiago Silva Torres ◽  
Kelika A Konda ◽  
E Hamid Vega-Ramirez ◽  
Oliver A Elorreaga ◽  
Dulce Diaz-Sosa ◽  
...  

PLoS ONE ◽  
2017 ◽  
Vol 12 (9) ◽  
pp. e0182838 ◽  
Author(s):  
Sin How Lim ◽  
Gitau Mburu ◽  
Adam Bourne ◽  
Joselyn Pang ◽  
Jeffrey A. Wickersham ◽  
...  

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