Are Anal Sex Roles Associated with Preferences for Pre-Exposure Prophylaxis Administration Modalities Among Men Who Have Sex with Men?

Abstract

The current study sought to examine awareness of, willingness to use, and preferences for available and theoretical administration modalities for HIV pre-exposure prophylaxis (PrEP) and the association of anal sex roles with these concepts among a sample of men who have sex with men (MSM) in Paris, France. Broadcast advertisements were placed on a popular geosocial-networking smartphone application for MSM to direct users to complete a Web-based survey. MSM answered questions on their recent engagement in condomless anal intercourse and awareness of and willingness to use PrEP in the form of once daily and event-driven pill regimens, long-acting injections, and penile and rectal microbicides as well as sexual roles. Multinomial regression models were fit to assess the association between behaviorally classified anal sexual role and preferences for one of these biomedical prevention modalities. A total of 482 HIV-uninfected MSM completed the survey, 48.1% of whom engaged in some form of condomless anal intercourse in the preceding 3 months. Most respondents (85.3%) had heard of once daily PrEP, but fewer respondents had heard of other prevention strategies. Assuming equal effectiveness, long-acting injections were the most commonly preferred (21.8%). Behaviorally defined "bottom" and "versatile" MSM more frequently preferred long-acting injections (32.9% of "bottoms" and 25.3% of "versatiles"). The development of long-acting injections to deliver antiretroviral drugs and topical microbicides may offer more convenient and acceptable options for HIV prevention among MSM, as MSM in this sample were willing to use them and would prefer to use them over currently available pill regimens.

Key population perceptions and opinions about long-acting antiretrovirals for prevention and treatment: a scoping review

“…Access, retention, and adherence are important limiting factors of the efficacy of both PrEP and ART programs, and long-acting (LA) drug development holds the promise to solve some of these backdrops and became a game changer in the management of HIV [2]. For PrEP, willingness to use LA among MSM increased in recent years, after the dissemination of preliminary positive results [3]. Convenience (easiness of use, integration into the routine, administration setting, etc.…”

Willingness to take long-acting injectable pre-exposure prophylaxis among men who have sex with men who participated in the CROPrEP study: a cross-sectional online study

“…This study also identified significant associations between the number of male sex partners, the HIV serological status of male sex partners, recreational drug use, HSV-2 infection status, and the willingness to take LAI-PrEP among MSM with oral PrEP experience. Previous studies reported on factors associated with MSM’ willingness to take LAI-PrEP or the preference for LAI-PrEP, including demographic (e.g., age [ 22 , 31 , 35 ], ethnicity [ 23 , 33 , 35 , 39 ], educational level [ 21 , 27 , 34 ], income [ 22 ], and insurance [ 39 ]), behavioural (e.g., sex roles [ 20 , 31 ], number of male sexual partners [ 34 , 35 ], HIV serological status of male sex partners [ 21 ], condom use [ 19 ], and HIV testing [ 20 ]), HIV risk perception-related [ 21 , 27 ], and PrEP-related factors (e.g., PrEP use experience [ 22 , 27 , 33 , 35 ]). The factors, such as demographic characteristics and HIV-related behaviours, in this study were similar to those in previous studies.…”

The Association Between Condomless Anal Sex and Social Support Among Black Men Who Have Sex With Men (MSM) in Six U.S. Cities: A Study Using Data from the HIV Prevention Trials Network BROTHERS Study (HPTN 061)

“…Therefore, our results compare individual and network variables between those who did and did not participate in this type of condomless sex during the past 6-month time period. We used two separate outcomes as recent literature has examined how HIV risk perception and one's ability to negotiate condom usage may differ depending on preferred sex roles in MSM [24]. Because each outcome was measured at both the initial assessment and subsequent follow-up visits, both variables were examined as repeated measures.…”

“…Rates of new infections are especially high for black men who have sex with men (MSM), with 2015 surveillance estimates indicating that black MSM accounted for almost 39% of all new HIV infections among MSM [2][3][4][5]. In addition, HIV diagnoses among young black MSM (i.e., ages [13][14][15][16][17][18][19][20][21][22][23][24] increased 87% between 2005 and 2014 [5]. The HIV Prevention Trials Network (HPTN) 061 study, the largest prospective cohort study among black MSM from six U.S. cities, found a high overall HIV incidence (3.0%) (5.9 percent for young black MSM ≤30 years old) [6].…”