Brief Report: PrEP Uptake, Adherence, and Discontinuation Among California YMSM Using Geosocial Networking Applications

Holloway, Ian W.; Dougherty, Ryan J.; Gildner, Jennifer; Beougher, Sean C.; Pulsipher, Craig; Montoya, John Harold Estrada; Plant, Aaron; Leibowitz, Arleen

doi:10.1097/qai.0000000000001164

“…For example, in the clinical trial study in Shanghai, actual uptake was only 2.5% compared to 19.1% of participants who said they were willing to use oral PrEP [22]. Therefore Concerns of side effects have been identified as one of the major reasons of not willing to use PrEP among study participants, this was consistent with previous studies among Chinese MSM [26,27] and MSM in other countries [28]. While there are some side effects when first starting the medication, such as nausea and frequent vomiting, they usually abate after two months into the regimen [4,29].…”

Section: Discussionsupporting

confidence: 84%

Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese Men who have sex with men

Su¹,

Si

²

,

Li

³

et al. 2019

Preprint

0

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Background Despite strengthened efforts on HIV prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China. Pre-exposure prophylaxis (PrEP), a highly effective HIV prevention tool, has recently been included in the China’s Action Plan of HIV Prevention and Control. To inform future PrEP implementation, this study is to identify barriers and facilitators of PrEP intention among MSM in China. Methods A cross-sectional survey was conducted among 300 MSM in Nanjing, Jiangsu Province in 2018. Demographic information, a 7-item high-risk behavior index, PrEP use intention, PrEP-related awareness and accessibility, and a 7-item public HIV stigma scale were included in the questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP intention. Results Overall, just 55.7% of participants had ever heard of PrEP, while 75.3% expressed willingness to use PrEP if efficacy was assured. Beliefs that ‘PrEP can prevent HIV if taken as prescribed (aOR=4.84, p<0.001), and ‘PrEP can be scaled up in the community’(aOR=3.24, p<0.001), were positively associated with PrEP intention. Concerns of side effects were negatively associated with PrEP intention (aOR=0.32, p =0.006). Conclusions Given the relatively low awareness of PrEP-related information in China, interventions on awareness and knowledge targeting high risk individuals and community are needed to scale up of oral PrEP implementation once approved by China FDA. Keywords MSM; HIV; PrEP; Intention

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“…PrEP among study participants, this was consistent with previous studies among Chinese MSM [36,37] and MSM in other countries [38]. While there are some side effects when first starting the medication, such as nausea and frequent vomiting, they usually abate after two months into the regimen [4,39].…”

Section: Concerns Of Side Effects Have Been Identified As One Of the supporting

confidence: 90%

Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese men who have sex with men

Su

¹

,

Si

²

,

Li

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

BackgroundDespite strengthened efforts on HIV prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China. Pre-exposure prophylaxis (PrEP), a highly effective HIV prevention tool, has recently been included in China’s Action Plan of HIV Prevention and Control. To inform future PrEP implementation, this study aims to identify the barriers and facilitators of PrEP intention among MSM in China. MethodsIn 2018, a cross-sectional survey was conducted among 300 MSM in Nanjing, Jiangsu Province. Questions on demographics, sexual behavior (including a 7-item high-risk behavior index), PrEP use intention, PrEP-related awareness and accessibility, and a 7-item public HIV stigma scale were included in the questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP intention. ResultsOverall, 44.67% had more than 2 male sexual partners and 5.56% had HIV-positive sexual partners. Just 57.00% had heard of PrEP and only 4 (1.33%) participants had used PrEP. However, 75.34% expressed a willingness to use oral PrEP if its efficacy was assured. Beliefs that ‘PrEP can prevent HIV if taken as prescribed’ (aOR=4.84, p<0.001), and ‘PrEP can be scaled up in the community’ (aOR=3.24, p<0.001), were positively associated with oral PrEP intention. Concerns of side effects were negatively associated with oral PrEP intention (aOR=0.32, p =0.006). Respectively 77.00% of the participants would choose injectable or implanted PrEP instead of oral PrEP. One of the PrEP stigma items, ‘Not certain if doctors can prescribe PrEP if I go to the clinic’ was positively associated with the intention to use injectable or implanted PrEP (aOR=3.03). Individuals who had heard of PrEP (aOR=2.74) and believed ‘PrEP can prevent HIV if taken as prescribed’ (aOR=2.65) were also positively related to the intention to use injectable or implanted PrEP. The most common concerns regarding PrEP use were efficacy (44.67%) and side effects (38.67%). The most common reasons for using injectable and implanted PrEP were adherence (81.94% and 77.86%, respectively) and privacy concerns (56.48% and 55.00%, respectively). Affordable price and coverage of health insurance are the driving factors for using PrEP. ConclusionsGiven the relatively low awareness of PrEP-related information in China, interventions on awareness and knowledge targeting high risk individuals and communities are needed. Furthermore, additional alternatives to prevent HIV, such as long-acting injectable or implanted PrEP, should be investigated to reduce the risk of HIV infection in at-risk MSM. Particularly, it is necessary to develop a more supportive social environment for MSM when implementing PrEP programs that are approved by China’s FDA.

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“…Recent research on reasons for discontinuation (regardless of whether ongoing PrEP is indicated) include cost, loss of insurance, stigma, change in risk perception, and concern about long-term side effects. [8][9][10] In addition, required quarterly follow-up clinic visits and laboratory testing have been considered a potential barrier to longer term persistence in PrEP care. [11][12][13][14][15] Indeed, a recent study conducted in San Francisco, a location with robust PrEP care, found that the most common reason for discontinuation was difficulty attending clinic visits or completing laboratory tests.…”

Section: Introductionmentioning

confidence: 99%

“A Good Habit”: Telehealth PrEP Users Find Benefit in Quarterly Monitoring Requirements

Koester

¹

,

Hughes

²

,

Grant

³

2020

J Int Assoc Provid AIDS Care

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In the United States, uptake of daily oral pre-exposure prophylaxis (PrEP) to prevent HIV continues to grow albeit at a slower than desired pace. Innovations in PrEP delivery systems may partially address structural challenges related to PrEP uptake and PrEP persistence, such as difficulty in attending clinic visits or completing laboratory testing. To study PrEP services offered by a telehealth company called Nurx, we conducted 31 in-depth interviews with prospective or current patients. We hypothesized that patients would find the quarterly laboratory monitoring requirements to be onerous especially in light of receiving all other aspects of PrEP care through a telehealth delivery system. However, interviewees characterized navigating laboratory systems as relatively easy and complying with the quarterly monitoring as a supplementary benefit of PrEP use. Our research illustrates that quarterly monitoring requirements are meaningful to some telehealth PrEP users and may facilitate persistent engagement in receipt of PrEP care.

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Brief Report: PrEP Uptake, Adherence, and Discontinuation Among California YMSM Using Geosocial Networking Applications

Cited by 130 publications

References 34 publications

Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese Men who have sex with men

Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese Men who have sex with men

Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese men who have sex with men

“A Good Habit”: Telehealth PrEP Users Find Benefit in Quarterly Monitoring Requirements

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