Are men who have sex with men at higher risk for HIV in Latin America more aware of PrEP?

Abstract

Introduction PrEP awareness in Latin America has been poorly characterized, with studies in Brazil, Mexico, and Peru highlighting awareness of 65% among gay, bisexual and other men who have sex with men (MSM). We assessed the association between higher risk of HIV infection, indicative of PrEP eligibility, and PrEP awareness among MSM from these countries. Methods This was a secondary analysis of a web-based survey advertised on social media platforms from March-June 2018 in Brazil, Mexico and Peru. Eligible individuals were cisgender MSM, ≥18 years old, HIV negative or of unknown status, who lived in these countries, and provided informed consent. Higher risk of HIV infection was defined as having 10 or more points in the HIV Risk Index for MSM (HIRI-MSM). We used multivariable Poisson regression models to calculate adjusted prevalence ratios (aPR) testing the association between higher risk for HIV and PrEP awareness. Results After exclusions, 19,457 MSM were included in this analysis. In Brazil, 53.8% were classified as higher risk for HIV, 51.9% in Mexico, and 54.2% in Peru. Higher risk for HIV was minimally associated with PrEP awareness among those in Brazil (aPR 1.04, 95% CI 1.01, 1.06), but no such association was observed in Mexico or Peru. Having more than a high school education, high income, daily use of geosocial networking (GSN) applications, and substance use were associated with PrEP awareness. Conclusion Higher risk of HIV infection was associated with increased PrEP awareness in Brazil. However, this association was weak indicating that PrEP awareness could be strengthened with further prevention efforts. In the remaining countries, results were non-conclusive between risk and awareness. Interventions to increase PrEP awareness are paramount to increase PrEP willingness and uptake and in turn prevent new HIV infections. Social media platforms could play an important role to achieve this goal.

Oral Pre-Exposure Prophylaxis Accessibility, Knowledge, Barriers, and Facilitators Among Men Who Have Sex With Men in Bulawayo, Zimbabwe

“…The logistic regression odds ratio reported no significant differences between age groups on the level of knowledge of PrEP. The findings contradict the study in Latin America by Assaf et al (2021), which reported an association between age and PrEP awareness (Assaf et al, 2021).…”

“…The logistic regression odds ratio reported no significant differences between age groups on the level of knowledge of PrEP. The findings contradict the study in Latin America by Assaf et al (2021) , which reported an association between age and PrEP awareness ( Assaf et al, 2021 ). Logistic regression odds ratio reported that Black MSM was knowledgeable as compared to other ethnic groups; these findings contradict the study findings of Kahle et al (2018) , which reported that knowledge levels were higher among White MSM than among other minority races ( Kahle et al, 2018 ).…”

Pre-exposure prophylaxis use, HIV knowledge, and internalized homonegativity among men who have sex with men in Brazil: A cross-sectional study

“… 38 , 39 Several previous studies exploring PrEP and HIV care in Brazil have found similar racial disparities as observed in the present study. 10 , 23 , 24 , 40 The PrEP Brasil study found Black YMSM had lower levels of protective concentrations of PrEP compared to White and Pardo YMSM, 10 and cross-sectional data have shown a greater awareness of and willingness to use PrEP among White compared to non-White MSM in Brazil. 23 , 24 , 40 Further research to understand the impact of intersectional stigma experienced by Black and Pardo MSM 41 is necessary to increase PrEP use in these populations.…”

Assessing the Underestimation of HIV Risk Infection among Young Men Who Have Sex with Men in Argentina

“…More than half of the YMSM in this study had a high actual risk, while only a quarter had a high self-perceived risk of HIV infection. A recent secondary analysis conducted in 2018 in Brazil, Mexico, and Peru found similar results: 53.3% of MSM had a high risk of contracting HIV based on their HIRI score, but only 24.7% perceived themselves to be at moderate risk [ 23 ]. The self-perceived risk of HIV tends to be lower than the HIRI score [ 23 , 24 ].…”

“…A recent secondary analysis conducted in 2018 in Brazil, Mexico, and Peru found similar results: 53.3% of MSM had a high risk of contracting HIV based on their HIRI score, but only 24.7% perceived themselves to be at moderate risk [ 23 ]. The self-perceived risk of HIV tends to be lower than the HIRI score [ 23 , 24 ]. Most of the MSM who met ≥10 cutoff criteria of the HIRI score did not perceive themselves to be at a moderate to high HIV risk, but higher HIRI scores were associated with higher self-perceived HIV risk.…”