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

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


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 ◽  
...  

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):  
Jeremias Salomão Chone ◽  
Shirley Verônica Melo Almeida Lima ◽  
Inês Fronteira ◽  
Isabel Amélia Costa Mendes ◽  
Ahmed Nabil Shaaban ◽  
...  

Objective: to investigate the factors associated with the practice of sex under the influence of drugs (chemsex) among Portuguese men who have sex with men during the period of social distancing to prevent the COVID-19. Method: online survey applied in May 2020 to a sample of 1,301 participants living in Portugal, recruited according to Respondent Driven Sampling and via social media Facebook®. Descriptive and bivariate analyses were performed along with logistic regression to calculate adjusted Odds Ratio (ORa). Results: the prevalence of chemsex was 20.2%. The likelihood of practicing chemsex increased with group sex (ORa: 28.4, 95%CI 16.93–47.49); unprotected sex (ORa: 7.1 95%CI 4.57–10.99); the use of pre-exposure prophylaxis (PrEP) to prevent COVID-19 (ORa: 4.2, 95%CI 2.71–6.39) and COVID-19 testing (ORa: 1.9, 95%CI 1.15–3.10). Conclusion: the practice of chemsex among men who have sex with men during the COVID-19 pandemic in Portugal was very frequent and may support greater understanding of the role and impact of sexual behavior on the COVID-19 transmission rates and the current pandemic situation in Portugal.


2021 ◽  
Vol 18 (1) ◽  
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 and has the potential to decrease the incidence of HIV in men who have sex with men (MSM). This study aimed to evaluate levels of PrEP acceptability and explore 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 participants were recruited through a nonprobability sampling method. The 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 included Zhuang or Han ethnic origin, recruitment through peer introduction or gay venues, pursuit of a higher education level, previous HIV testing and oral sex with a man. Conversely, having casual sex in the past 6 months was associated with a 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 implementation strategies to promote PrEP acceptance among MSM.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053634
Author(s):  
Simin Yu ◽  
Wendy Cross ◽  
Louisa Lok Yi Lam ◽  
Kaili Zhang ◽  
Biswajit Banik ◽  
...  

ObjectiveTo explore willingness and preferred ways to use HIV pre-exposure prophylaxis (PrEP), factors associated with willingness, and potential barriers to PrEP use among men who have sex with men (MSM) in Changsha, China.DesignA cross-sectional survey was conducted from 25 June to 31 August 2019. Two hundred and fifty-five MSM were recruited from three community-based organisations (CBOs) in Changsha City. Willingness and potential barriers to use PrEP were examined using researcher-created scales. Univariate and multivariate logistic regression was used to analyse the factors associated with willingness to use PrEP. P values <0.05 were considered significant.SettingThree MSM inclusive CBOs in Changsha, Hunan Province, China.Participants255 HIV-negative MSM were recruited through their CBOs with snowball sampling.ResultsLess than half of the participants (43.1%) had heard of PrEP and 15.3% were willing to use PrEP. The participants reported higher willingness to use event-driven PrEP (3.70±0.07) than daily PrEP (2.65±0.07). Higher self-rated risk and fear of contracting HIV (OR: 14.47, 95% CI 2.19 to 95.53), awareness of PrEP (OR: 4.20, 95% CI 1.64 to 10.73), sharing one’s own sexual orientation with parents or siblings (OR: 2.52, 95% CI 1.54 to 7.20) and having a university education or above (OR:0.29, 95% CI 0.12 to 0.72) were associated with willingness to use PrEP. Only 12.2% of the sample was concerned about potential barriers to PrEP use.ConclusionEfforts to improve awareness and knowledge of PrEP, teach self-evaluation of HIV infection risk and provide social and emotional support for MSM are needed to scale up PrEP implementation in China.


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