Awareness of, Willingness to Take PrEP and Its Actual Use Among Belgian MSM at High Risk of HIV Infection: Secondary Analysis of the Belgian European MSM Internet Survey

Abstract

We examined PrEP awareness, willingness to take it and early PrEP use among men who have sex with men (MSM) at increased risk of HIV acquisition in Belgium. This analysis of the Belgian EMIS data of 2017-2018 adopts a cascade approach, with the following steps quantified as conditional probabilities: being eligible for, aware of, and willing to take PrEP and PrEP use. One out of three MSM was eligible to use PrEP according to the operationalized Belgian reimbursement criteria. PrEP awareness was lower among socioeconomically vulnerable MSM, MSM living outside large cities, MSM who were less open about their sexuality and who did not identify as gay or homosexual. A lack of PrEP knowledge, a higher level self-efficacy regarding safe sex, having a steady partner and a higher risk of depression were related to unwillingness to use PrEP. Among those willing to take PrEP, less than one third were actually using PrEP. Not using PrEP was associated with living in small cities and experiencing financial problems. Keywords (4-5):Pre-exposure prophylaxis (PrEP) use, Cascade approach, Men who have Sex with Men (MSM), eligibility criteria, awareness of and willingness to use PrEP

Estimating Partnership Duration among MSM in Belgium—A Modeling Study

“…Based on the EMIS-2017 data, we estimated that 34.6% (32.87–36.45; 95% CI) of the Belgian MSM population would be eligible to receive Pre-Exposure Prophylaxis (PrEP). This estimate is similar to estimates from previously published studies from Belgium and Europe [ 62 , 64 , 65 ]. According to the other two definitions of high-activity MSM, 30.41% (28.69–32.19; 95% CI) and 27.90% (26.23–29.64; 95% CI) of the EMIS-2017 participants reported more than 15 total and casual partners over a 12-month period, respectively.…”

How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium

“…Notably, almost all (96%) PrEP starters in 2020 fell under the classification of ‘men who have sex with men’ (MSM), while about half of all new diagnoses in Belgium are attributed to heterosexual sex ( 21 ). Surveys conducted in 2014 and 2017, respectively among people with a sub-Saharan African migrant background and MSM living in Belgium, also found that about one third of both populations (30.3 and 33.2%, respectively) was eligible for PrEP according to Belgian eligibility criteria (see Supplementary Material 1 ) ( 24 , 25 ). Wary of their limited generalizability, these data suggest a remaining unmet need for PrEP in Belgium.…”

Risk and Protective Profile of Men Who Have Sex With Men Using Mobile Voluntary HIV Counseling and Testing: Latent Class Analysis

“…The proportion of participants aged ≥40 years in class 1 was 7.6% higher than that of class 2 and the proportion having a monthly income of ≤US $713 in class 1 was 7.5% higher than that of class 2. Older MSM may have a poorer economic status and were less likely to be aware, or have an inappropriate understanding of, PrEP than MSM ≤30 years old, which made them less likely to use it [41,42]. Improving HIV prevention may involve providing counseling on PEP and PrEP use during HIV testing for high-risk targets, including basic knowledge, side effect management, using reminders to ensure compliance, and providing financial and social support that increases the likelihood of preventive medication use [43].…”