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PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey.

ABSTRACT: INTRODUCTION:HIV incidence among men who have sex with men (MSM) is high in China. Pre-exposure prophylaxis (PrEP) is a promising mean to prevent HIV transmission but it is not widely available in China. We conducted a large Internet-based online survey to assess the willingness of Chinese MSM to take PrEP and associated factors to their uptake preferences. METHODS:Between 19 January and 6 February, 2017, 4581 MSM aged over 15 years were recruited via a social networking app to take an online PrEP survey. HIV status at the time of the survey being conducted was not one of recruitment criteria. Participants were asked if they had heard of PrEP, if they had concerns about PrEP, and if they would be ready to uptake PrEP should it be provided. When asked if participants were willing to take PrEP, they were asked to select from the following responses: "definitely not," "probably not," "not sure," "probably yes," and "definitely yes." In the final analysis, we grouped these five-level Likert scale responses into three-level responses as "definitely yes," "probably yes," and "no (definitely not/probably not/not sure)." Descriptive analysis and multinomial logistic regressions were conducted to assess the associations of PrEP adoption readiness and uptake concerns with HIV risk behaviours and demographic characteristics. RESULTS:MSM from 33 geographical regions of China participated in the survey. The majority were younger than 25 (65.2%) and had attended college (68.6%). HIV prevalence was high (6.8%) and 43.3% reported a history of unprotected anal sex. Only 22.4% of participants had heard of PrEP. When asked if they would uptake PrEP, 26.0% said "definitely yes," 49.6% were "probably yes," and 24.4% said "no." PrEP adoption readiness was associated with having previously heard of PrEP and expressing concerns about accessibility and cost. Worries about side effects, low perceived HIV risk, preference for condoms, and never having received HIV testing were negatively associated with PrEP uptake willingness. CONCLUSION:Young and well-educated Chinese MSM reported a low willingness to uptake PrEP despite being high-risk for HIV. Effective education, especially through online mediums, will be critical to optimize this group's PrEP uptake.

SUBMITTER: Han J

PROVIDER: S-EPMC6364490 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey.

Han Jing J Bouey Jennifer Zh JZ Wang Liming L Mi Guodong G Chen Zihuang Z He Ying Y Viviani Tara T Zhang Fujie F

Journal of the International AIDS Society 20190201 2

<h4>Introduction</h4>HIV incidence among men who have sex with men (MSM) is high in China. Pre-exposure prophylaxis (PrEP) is a promising mean to prevent HIV transmission but it is not widely available in China. We conducted a large Internet-based online survey to assess the willingness of Chinese MSM to take PrEP and associated factors to their uptake preferences.<h4>Methods</h4>Between 19 January and 6 February, 2017, 4581 MSM aged over 15 years were recruited via a social networking app to ta ...[more]

PMID: 30724470

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Project description:BackgroundMen who have sex with men (MSM) are at high risk of HIV acquisition. Long-acting injectable-pre-exposure prophylaxis (LAI-PrEP), requiring less frequent dosing, is being studied as an alternative method to daily oral HIV PrEP. With the addition of this potential new prevention method, it expands the scope for a wider user choice and is expected to increase the acceptability and uptake of HIV prevention measures. The aim of our study was to explore the willingness to use LAI-PrEP and associated influential factors.MethodsParticipants were recruited from December 2020 to March 2021 through banner advertisements on web- and mobile app-based platforms on Blued, a large gay Chinese social media platform. MSM in our cross-sectional study was HIV-negative and currently lived in mainland China. Participants were asked about their willingness to use LAI-PrEP and reasons why they might be or not be willing to use LAI-PrEP. Multivariable logistic regression was used to analyze the factors associated with the willingness to use LAI-PrEP.ResultsIn total, 969 participants met the inclusion criteria and finished the survey. Nearly twenty percent (19.5%) of participants had never tested for HIV; 66.8% of MSM had multiple male partners; and 51.6% of MSM engaged in condomless sex with their partner. About three-fifths (66.3%) of MSM were aware of PrEP, and only 3.9% of MSM had used PrEP before. The willingness to use LAI-PrEP among MSM was 74.0% (95% CI: 71.4%-76.6%). MSM with higher education levels were less likely to show a willingness to use LAI-PrEP (AOR = 0.56, 95%CI: 0.38-0.84). Participants who had a history of HIV test (AOR = 1.68, 95%CI: 1.11-2.55), were willing to use daily oral PrEP (AOR = 10.64, 95%CI:7.43-15.21), had multiple male sexual partners (AOR = 1.33, 95%CI:0.93-1.90), who used rush popper(AOR = 1.49, 95%CI:1.05-2.13), and who were aware of PEP (AOR = 1.66, 95%CI: 1.02-2.70) were more likely to show willingness to use LAI-PrEP.ConclusionsIn our study, MSM had quite high awareness but low uptake of PrEP. As LAI-PrEP is expected to be approved for use in China in the future, our study of MSM highlights the need for key population-focused education programs about PrEP and healthy sexual behavior. This study also provides some evidence for LAI-PrEP use among the Chinese MSM population in the future.

Dataset Information

PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey.

Publications

PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey.

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