Acceptability and willingness to use HIV pre-exposure prophylaxis among HIV-negative men who have sex with men in Switzerland

Abstract

Pre-exposure prophylaxis (PrEP) is discussed as an additional HIV prevention method targeting men who have sex with men (MSM). So far, PrEP has not been approved in Switzerland and only little is known about the acceptability of PrEP among MSM living in Switzerland. Given the slow uptake of PrEP among MSM in the USA, the objectives of the study were to investigate the acceptability for PrEP and to identify factors influencing the acceptability for this prevention method and the willingness to adopt it. During a 4-month period we conducted five focus group discussions with 23 consecutively sampled HIV-negative MSM aged 22–60 years living in Switzerland. We analyzed the data according to qualitative content analysis. The acceptability of PrEP varied considerably among the participants. Some would use PrEP immediately after its introduction in Switzerland because it provides an alternative to condoms which they are unable or unwilling to use. Others were more ambivalent towards PrEP but still considered it (1) an additional or alternative protection to regular condom use, (2) an option to engage in sexual activities with less worries and anxieties or (3) a protection during receptive anal intercourse independently of the sexual partner's protective behaviour. Some participants would not consider using PrEP at all: they do not see any benefit in PrEP as they have adopted safer sex practices and did not mention any problems with condom use. Others are still undecided and could imagine using an improved form of PrEP. The results provide a valuable basis for a model explaining the acceptability of PrEP among MSM and suggest including the personal HIV protection strategy in the considerations adopted.

Awareness and Acceptability of Pre-Exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men in Kazakhstan: A Mixed Methods Study

“…The main reasons for Kazakhstani MSM to be interested in PrEP related to increased safety and control of HIV prevention. Interviewees revealed severe anxiety about HIV transmission and were enthusiastic about additional protection, similar to findings from previous qualitative studies in which PrEP was regarded as an option to engage in worry free sex, and as protection that is independent of sexual partners' behaviour [36,37]. This anticipated empowering effect was confirmed by Collins et al [38] who showed that PrEP "reduced fear and shame associated with sex and facilitated greater sexual satisfaction and intimacy" (p. 55).…”

Pre-exposure prophylaxis among men who have sex with men in the Amsterdam Cohort Studies: Use, eligibility, and intention to use

“…As observed in the 2012 study, this includes increasing PrEP knowledge; addressing psychosocial determinants such as feelings of shame and perception of self-efficacy; and encouraging the use of condoms or other risk reduction strategies alongside increasing PrEP accessibility [ 11 , 21 ]. We furthermore expect PrEP intention and use to increase with increasing awareness and decreasing PrEP costs [ 10 , 20 – 22 ]. This is supported by the observed increasing proportion of recent self-obtaining PrEP users.…”

Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey

“…A recent meta-analysis estimated the acceptability of using PrEP among MSM to be 57.8% globally [ 7 ]. Outside of Asia, research on acceptability of PrEP among MSM has been conducted mostly in the United States of America [ 8 – 22 ], followed by United Kingdom [ 23 – 26 ], Australia [ 27 – 29 ], Brazil [ 30 ], Canada [ 31 – 33 ], France [ 34 , 35 ], Kenya [ 36 ], Netherlands[ 37 ], Peru [ 38 ], Portugal [ 39 ], Switzerland[ 40 ], and Spain [ 41 ]. Other studies have assessed acceptability of PrEP using surveys that included MSM from multiple countries [ 42 , 43 ].…”