Attitudes Towards Treatment as Prevention Among PrEP-Experienced Gay and Bisexual Men in Australia

Abstract

The introduction of HIV pre-exposure prophylaxis (PrEP) has the potential to impact the attitudes gay and bisexual men (GBM) who consequently choose to take PrEP have towards treatment as prevention (TasP), and the extent to which they are willing to have condomless anal intercourse (CLAI) with an HIV-positive sexual partner who has an undetectable viral load (UVL). Using a cross-sectional sample from an observational cohort study conducted from August 2018 to March 2020, we examined the extent to which PrEP-experienced GBM are willing to have CLAI with a partner who has a UVL. Simple and multiple logistic regression models were used to identify associated variables. Of the 1386 participants included in the analyses, 79.0% believed in the effectiveness of TasP, and 55.3% were willing to have CLAI with a partner who has a UVL. Wiling participants were less worried about getting HIV when taking PrEP and more likely to believe in TasP. Further research is needed to better understand the gap between belief in TasP and willingness to have CLAI with a partner who has a UVL among PrEP-experienced GBM.

Familiarity with, perceived accuracy of, and willingness to rely on Undetectable=Untransmittable (U=U) among gay and bisexual men in Australia: results of a national cross-sectional survey

“…Our results showed the highest level of confidence in relying on U=U recorded to date among GBM in Australia. 26,27,29 Consistent with previous research, we found that knowledge of and belief in U=U was concentrated among people living with HIV, followed by PrEP users. 15,23 The lowest levels of familiarity, perceived accuracy and willingness to rely upon U=U were among HIV-negative and untested men who were not using PrEP (some of the groups who might benefit from greater knowledge of U=U).…”

“…25 Previous Australian research has not evaluated familiarity with the specific U=U message or its perceived accuracy. Previous research has assessed the willingness of Australian GBM to have condomless sex with a partner living with HIV who has an undetectable viral load, and found low levels of willingness, [26][27][28][29] particularly among HIV-negative and untested men who do not use PrEP. However, most of this research was conducted before the U=U campaign gathered momentum and did not explicitly ask participants whether they were familiar with the U=U message, believed in its accuracy, or were willing to rely upon an undetectable viral load when having condomless sex with partners living with HIV.…”