Awareness of Pre-exposure Prophylaxis for HIV, Willingness to Use It and Potential Barriers or Facilitators to Uptake Among Men Who Have Sex with Men in Spain

Ferrer, Laia; Folch, Cinta; Fernández‐Dávila, Percy; Garcia, A.; Morales, Alexandra; Belda, J; Susperregui, A. R.; Casabona, Jordi

doi:10.1007/s10461-016-1379-9

Cited by 30 publications

(29 citation statements)

References 29 publications

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“…Previous studies showed mixed results for the influence of sampling strategies on findings regarding interest in PrEP. Beymer et al (2018), for example, reported higher interest in PrEP among visitors to an STI clinic compared to online participants, while Ferrer et al (2016) reported lower interest among visitors to an STI clinic compared to online participants. Overall, the pattern of results across studies is diverse, confirming our notion that recruitment strategies and sample characteristics can play a major role in explaining different findings.…”

Section: Discussionmentioning

confidence: 97%

PrEP Interest Among Men Who Have Sex with Men in the Netherlands: Covariates and Differences Across Samples

Dijk

Duken

Delabre³

et al. 2020

Arch Sex Behav

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Despite increased availability of pre-exposure prophylaxis (PrEP), PrEP uptake has remained low. To promote uptake, factors related to PrEP interest among relevant target populations warrant investigation. The aim of this study was to provide an analysis of PrEP interest among men who have sex with men (MSM) in the Netherlands, while taking study recruitment strategies into account. We recruited 154 MSM from an LGBT research panel (AmsterdamPinkPanel) and 272 MSM from convenience sampling. Both samples were part of the Flash! PrEP in Europe Survey and were compared on their PrEP interest, usage intentions, and sexual behavior. We conducted logistic regression analyses to discover variables associated with PrEP interest and intentions. Participants from the AmsterdamPinkPanel were less likely to use PrEP, had less knowledge of PrEP, and were less interested in PrEP than participants from convenience sampling. Significant covariates of PrEP interest were being single, more prior PrEP knowledge, sexual risk behaviors, such as not having used a condom during last sex and having ever used drugs in a sexual context, and not participating in the AmsterdamPinkPanel. Adding the recruitment strategy to the regression increased explained variance on top of predictors already described in the literature. Increased sexual risk behavior is related to increased PrEP interest and it helps to identify PrEP target groups. Recruitment strategies have a substantial impact on findings regarding PrEP interest and usage intentions. This study emphasizes the importance of using multiple strategies for recruiting participants to obtain a more comprehensive view of MSM's attitudes toward PrEP.

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Section: Discussionmentioning

confidence: 97%

PrEP Interest Among Men Who Have Sex with Men in the Netherlands: Covariates and Differences Across Samples

Dijk

Duken

Delabre³

et al. 2020

Arch Sex Behav

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“…A 2012 study reported that only 28.2% of Australian MSM were willing to use PrEP [57]. More recently, in Europe, proportions of MSM willing to use PrEP have ranged from 47.8% to 54.3% in Scotland [58,59], 57.0% in Portugal [60] and 57.6 % in Spain [61]. Recent Canadian studies reported willingness to use PrEP of 55.0% [62,63].…”

Section: Discussionmentioning

confidence: 99%

“…Differentiating PrEP from PEP to potential adopters in LMIC would be important, at least initially. Studies from high-income settings such as Spain [61] have demonstrated the importance of awareness in determining willingness to use PrEP. Beyond just hearing about PrEP, the way in which PrEP information is provided to MSM, and how well they were able to understand it, could influence their levels of willingness to use it.…”

Section: Discussionmentioning

confidence: 99%

Awareness and willingness to use HIV pre‐exposure prophylaxis among men who have sex with men in low‐ and middle‐income countries: a systematic review and meta‐analysis

Tuot²,

Mwai³

et al. 2017

Journal of the International AIDS Society

130

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Introduction: To facilitate provision of pre-exposure prophylaxis (PrEP) in low- and middle-income countries (LMIC), a better understanding of potential demand and user preferences is required. This review assessed awareness and willingness to use oral PrEP among men who have sex with men (MSM) in LMIC.Methods: Electronic literature search of Cochrane library, Embase, PubMed, PsychINFO, CINHAL, Web of Science, and Google Scholar was conducted between July and September 2016. Reference lists of relevant studies were searched, and three authors contacted for additional data. Non-peer reviewed publications were excluded. Studies were screened for inclusion, and relevant data abstracted, assessed for bias, and synthesized.Results: In total, 2186 records were identified, of which 23 studies involving 14,040 MSM from LMIC were included. The proportion of MSM who were aware of PrEP was low at 29.7% (95% CI: 16.9–44.3). However, the proportion willing to use PrEP was higher, at 64.4% (95% CI: 53.3–74.8). Proportions of MSM aware of PrEP was <50% in 11 studies and 50–70% in 3 studies, while willingness to use PrEP was <50% in 6 studies, 50–70% in 9 studies, and over 80% in 5 studies. Several factors affected willingness to use PrEP. At the individual domain, poor knowledge of PrEP, doubts about its effectiveness, fear of side effects, low perception of HIV risk, and the need to adhere or take medicines frequently reduced willingness to use PrEP, while PrEP education and motivation to maintain good health were facilitators of potential use. Demographic factors (education, age, and migration) influenced both awareness and willingness to use PrEP, but their effects were not consistent across studies. At the social domain, anticipated stigma from peers, partners, and family members related to sexual orientation, PrEP, or HIV status were barriers to potential use of PrEP, while partner, peer, and family support were facilitators of potential use. At the structural domain, concerns regarding attitudes of healthcare providers, quality assurance, data protection, and cost were determinants of potential use.Conclusions: This review found that despite low levels of awareness of PrEP, MSM in LMIC are willing to use it if they are supported appropriately to deal with a range of individual, social, and structural barriers.

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“…Further to this, our sample had a relatively good awareness of PrEP, having participated in a previous online PrEP survey, and therefore may not be similar to all MSMs in Malaysia. Awareness of PrEP is a critical determinant of willingness and acceptability to use it [ 31 ], and therefore public health implementation will require heavy focus on effective information dissemination and promotion of PrEP.…”

Section: Discussionmentioning

confidence: 99%

Willingness to use pre‐exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study

Bourne

Cassolato

Wei

et al. 2017

Journal of the International AIDS Society

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Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake.Methods: As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis.Results: Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to “at-risk” men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours.Conclusions: This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those taking it may be stigmatized, it is crucial that the use of PrEP is presented as a responsible course of action, and one of a range of strategies that men can use to keep themselves safe from HIV.

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Awareness of Pre-exposure Prophylaxis for HIV, Willingness to Use It and Potential Barriers or Facilitators to Uptake Among Men Who Have Sex with Men in Spain

Cited by 30 publications

References 29 publications

PrEP Interest Among Men Who Have Sex with Men in the Netherlands: Covariates and Differences Across Samples

PrEP Interest Among Men Who Have Sex with Men in the Netherlands: Covariates and Differences Across Samples

Awareness and willingness to use HIV pre‐exposure prophylaxis among men who have sex with men in low‐ and middle‐income countries: a systematic review and meta‐analysis

Willingness to use pre‐exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study

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