Willingness to Use and Adhere to HIV Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in China

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.

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Factors Associated With Willingness to Use Oral Pre-exposure Prophylaxis (Prep) Among Fishing Communities in Peri-urban Kampala, Uganda

10.21203/rs.3.rs-265902/v1 ◽

2021 ◽

Author(s):

Bashir Ssuna ◽

Anne Katahoire ◽

Mari Armstrong-Hough ◽

Dennis Kalibbala ◽

Joan N Kalyango ◽

...

Keyword(s):

Focus Group ◽

Fishing Communities ◽

Key Populations ◽

Focus Group Discussions ◽

Group Discussions ◽

Factors Associated ◽

The Past ◽

Willingness To Use ◽

Exposure Prophylaxis ◽

Oral Prep

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.

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Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men

AIDS and Behavior ◽

10.1007/s10461-016-1565-9 ◽

2016 ◽

Vol 21 (5) ◽

pp. 1336-1349 ◽

Cited By ~ 48

Author(s):

George J. Greene ◽

Greg Swann ◽

Angela J. Fought ◽

Alex Carballo-Diéguez ◽

Thomas J. Hope ◽

...

Keyword(s):

Hiv Prevention ◽

Sex With Men ◽

Long Acting ◽

Exposure Prophylaxis ◽

Oral Prep

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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)

10.2196/preprints.13771 ◽

2019 ◽

Author(s):

Thiago Silva Torres ◽

Kelika Konda ◽

E. Hamid Vega-Ramirez ◽

Oliver Antonio Elorreaga Reyes ◽

Dulce Diaz-Sosa ◽

...

Keyword(s):

Latin American ◽

Online Survey ◽

Sex Partners ◽

Anal Sex ◽

Factors Associated ◽

Sex With Men ◽

Prep Awareness ◽

Willingness To Use ◽

Exposure Prophylaxis ◽

Oral Prep

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.

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Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States

American Journal of Men s Health ◽

10.1177/1557988318790875 ◽

2018 ◽

Vol 12 (6) ◽

pp. 1824-1834 ◽

Cited By ~ 4

Author(s):

Akshay Sharma ◽

Erin M. Kahle ◽

Stephen P. Sullivan ◽

Rob Stephenson

Keyword(s):

Hiv Prevention ◽

Birth Cohort ◽

Perceived Risk ◽

The United States ◽

Prevention Strategies ◽

The Past ◽

Hiv Prevention Strategies ◽

Functional Knowledge ◽

Sex With Men ◽

Exposure Prophylaxis

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.

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Prepared for PrEP: preferences for HIV pre-exposure prophylaxis among Chinese men who have sex with men in an online national survey

BMC Infectious Diseases ◽

10.1186/s12879-019-4692-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Wenting Huang ◽

Dan Wu ◽

Jason J. Ong ◽

M. Kumi Smith ◽

Fan Yang ◽

...

Keyword(s):

National Survey ◽

Secondary Analysis ◽

Chinese Men ◽

Sex With Men ◽

Partner Types ◽

Long Acting ◽

Negotiated Safety ◽

Exposure Prophylaxis ◽

Larger Sample ◽

Oral Prep

Abstract Background Pre-exposure prophylaxis (PrEP) is not widely available in China. Previous studies reported low awareness and inconclusive findings on the acceptability of PrEP among Chinese men who have sex with men (MSM). Methods We conducted a secondary analysis of an online national survey comparing preferences for oral and long-acting injectable PrEP among MSM and identifying correlates of preferences. The study did not collect detailed information about partner types that may influence negotiated safety and PrEP uptake. Results Nine-hundred and seventy-nine men from the larger sample of 1045 men responded to the PrEP survey questions. Most men (81.9%) had never heard of PrEP, but reported interest in using PrEP. More participants chose injectable PrEP (36.3%) as their preferred formulation than oral PrEP (24.6%). Men who had at least two HIV tests (adjusted OR = 1.36, 95%CI 1.04, 1.78) more commonly preferred injectable PrEP. Conclusion Our findings may help inform PrEP messaging in areas where PrEP has yet to be scaled up.

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Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study

Journal of the International AIDS Society ◽

10.7448/ias.20.1.21899 ◽

2017 ◽

Vol 20 (1) ◽

pp. 21899 ◽

Cited By ~ 14

Author(s):

Adam Bourne ◽

Matteo Cassolato ◽

Clayton Koh Thuan Wei ◽

Bangyuan Wang ◽

Joselyn Pang ◽

...

Keyword(s):

Hiv Prevention ◽

Qualitative Study ◽

Sex With Men ◽

Willingness To Use ◽

Exposure Prophylaxis

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Willingness to use HIV pre-exposure prophylaxis and associated factors among men who have sex with men in Liuzhou, China

10.21203/rs.3.rs-336411/v1 ◽

2021 ◽

Author(s):

Yuansheng Fu ◽

Akililu Alemu Ashuro ◽

Xianxiang Feng ◽

Ting Wang ◽

Sichen Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Sexual Behaviors ◽

Study Participant ◽

Casual Sex ◽

Multivariate Logistic Regression ◽

Factors Associated ◽

Hiv Test ◽

Sex With Men ◽

Willingness To Use ◽

Exposure Prophylaxis

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.

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Prepared for PrEP: Preferences for HIV pre-exposure prophylaxis among Chinese men who have sex with men in an online national survey

10.21203/rs.2.11005/v3 ◽

2019 ◽

Author(s):

Wenting Huang ◽

Dan Wu ◽

Jason O. Ong ◽

M. Kumi Smith ◽

Fan Yang ◽

...

Keyword(s):

National Survey ◽

Secondary Analysis ◽

Chinese Men ◽

Sex With Men ◽

Partner Types ◽

Long Acting ◽

Negotiated Safety ◽

Exposure Prophylaxis ◽

Larger Sample ◽

Oral Prep

Abstract Background: Pre-exposure prophylaxis (PrEP) is not widely available in China. Previous studies reported low awareness and inconclusive findings on the acceptability of PrEP among Chinese men who have sex with men (MSM). Methods: We conducted a secondary analysis of an online national survey comparing preferences for oral and long-acting injectable PrEP among MSM and identifying correlates of preferences. The study did not collect detailed information about partner types that may influence negotiated safety and PrEP uptake. Results: Nine-hundred and seventy-nine men from the larger sample of 1045 men responded to the PrEP survey questions. Most men (81.9%) had never heard of PrEP, but reported interest in using PrEP. More participants chose injectable PrEP (36.3%) as their preferred formulation than oral PrEP (24.6%). Men who had at least two HIV tests (adjusted OR = 1.36, 95%CI 1.04, 1.78) more commonly preferred injectable PrEP. Conclusion: Our findings may help inform PrEP messaging in areas where PrEP has yet to be scaled up.

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