Incorrect Knowledge of Event-Driven PrEP “2-1-1” Dosing Regimen Among PrEP-Experienced Gay and Bisexual Men in Australia

Chan, Curtis; Vaccher, Stefanie; Fraser, Douglas; Grulich, Andrew E.; Holt, Martin; Zablotska‐Manos, Iryna; Prestage, Garrett; Bavinton, Benjamin R.

doi:10.1097/qai.0000000000002935

Cited by 5 publications

(10 citation statements)

References 40 publications

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“…PrEP-experienced GBM were more likely to be aware of ED-PrEP and have correct knowledge, potentially because they are likely to have engaged with PrEP information while taking PrEP, and more likely to be aware of developments in PrEP than those who have never initiated PrEP. Our sample reported ED-PrEP use at 14.4% among PrEP-experienced participants, which is higher compared to previous pre-coronavirus disease 2019 (COVID-19) Australian samples at roughly 5-10% 17,26 but comparable to studies conducted after the onset of COVID-19. 9 The increase in knowledge may reflect increased uptake, as GBM who utilised ED-PrEP are more likely to seek out how to take ED-PrEP than those who had no intention of taking ED-PrEP.…”

Section: Discussionsupporting

confidence: 55%

“…Previous work in mostly PrEP-experienced samples in Australia had found only one-third of GBM were aware of ED-PrEP in 2018, 12 and this had increased to two-thirds by the start of 2020. 17 Compared to these early adopters of PrEP, our sample, recruited in 2021, with approximately half PrEP-experienced and non-PrEPexperienced participants, had overall comparable levels of ED-PrEP awareness to highly engaged PrEP users. The incorporation of ED-PrEP into Australian PrEP prescribing guidelines in 2019 and the social marketing campaigns in 2020 may have contributed to the increased awareness of ED-PrEP between 2018 and 2021.…”

Section: Discussionmentioning

confidence: 94%

“…Despite poorer knowledge among non-PrEP-experienced GBM, their knowledge was still higher than previous PrEP-experienced samples that showed only one-eighth of PrEP early adopters in Australia had correct knowledge. 17 As with awareness, the increase in knowledge could be attributable to the changes to the PrEP guidelines as well as time passing for the circulation of these changes in community, social, and clinical settings. Factors associated with ED-PrEP awareness and knowledge were consistent with previous work.…”

Section: Discussionmentioning

confidence: 99%

“…This method has not yet received regulatory approval from the Therapeutic Goods Administration, the medicine and therapeutic regulatory agency of the Australian Government, 14 which could lead to hesitancy to discuss it with potential PrEP patients among clinicians and reluctance from clinicians to provide off-label prescriptions. 15,16 Furthermore, there is evidence that GBM who are aware of ED-PrEP may not know how to take it correctly, 17 and some studies have shown many GBM often miss the loading dose. 18,19 A 2020 study of PrEP-experienced Australian GBM found that only one-eighth of those aware of ED-PrEP knew how to take it correctly.…”

Section: Introductionmentioning

confidence: 99%

“…18,19 A 2020 study of PrEP-experienced Australian GBM found that only one-eighth of those aware of ED-PrEP knew how to take it correctly. 17 Incorrect knowledge of how to take ED-PrEP is a cause of concern as missing doses is likely to increase the risk of HIV infection. 20 In Australia, HIV prevention education among GBM is largely implemented by government-funded communitybased organisations, and comprises large-scale digital, print, and outdoor social marketing campaigns, targeted digital social marketing, group-and individual-level peer education, and community development.…”

Section: Introductionmentioning

confidence: 99%

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Increased awareness of event-driven PrEP and knowledge of how to use it: results from a cross-sectional survey of gay and bisexual men in Australia

et al. 2022

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For full list of author affiliations and declarations see end of paper Background. Recent changes to Australian PrEP prescribing guidelines support the use of eventdriven pre-exposure prophylaxis (ED-PrEP) to prevent HIV among gay and bisexual men (GBM). Social marketing campaigns to increase awareness of ED-PrEP were conducted in early 2021. This study aimed to assess the awareness and knowledge of this method after these campaigns. Methods. We conducted a national cross-sectional online survey about PrEP knowledge and attitudes from March to May 2021. Participants were asked if they had heard of ED-PrEP. Among aware participants, questions about the '2-1-1' method were asked to assess knowledge. Bivariate and multivariate logistic regression analyses were conducted to assess the characteristics of those who were aware of ED-PrEP, and those who had correct knowledge of ED-PrEP. Analysis was restricted to non-HIV-positive cis-GBM who were aware of PrEP. Results. Among the 419 participants eligible for this analysis, 286 (68.3%) had heard of ED-PrEP. Awareness was associated with living in a postcode with ≥10% gay men, PrEP experience, and belief ED-PrEP is effective. Of these 286 participants, 125 (43.7%) correctly answered questions about how to take ED-PrEP. Correct knowledge was associated with PrEP experience and belief ED-PrEP is effective. Conclusions. A growing proportion of GBM are aware of ED-PrEP, but many still do not know how to take it as per clinical guidelines. More work is needed to increase knowledge among GBM to promote effective use of this method.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increased awareness of event-driven PrEP and knowledge of how to use it: results from a cross-sectional survey of gay and bisexual men in Australia

et al. 2022

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Trajectories of PrEP use among men who have sex with men: a pooled analysis of two prospective, observational cohort studies

et al. 2023

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Introduction: Daily and event-driven oral pre-exposure prophylaxis (PrEP) reduce the risk of HIV acquisition. PrEP use can vary over time, yet little is known about the trajectories of PrEP use irrespective of the chosen PrEP regimens among men who have sex with men (MSM). Methods: Using data from a mobile, web-based diary application collected daily from 17 August 2015 until 6 May 2018, we analysed PrEP use and sexual behaviour in two large cohorts, AMPrEP (Amsterdam, the Netherlands) and Be-PrEP-ared (Antwerp, Belgium). In both cohorts, participants could choose between daily and event-driven oral PrEP every 3 months. We used group-based trajectory modelling to identify trajectories of PrEP use over time and their determinants. In addition, we estimated the incidence rate of chlamydia, gonorrhoea and syphilis within these trajectories. Results: We included 516 MSM (n = 322 AMPrEP; n = 194 Be-PrEP-ared), of whom 24% chose event-driven PrEP at PrEP initiation. Participants contributed 225,015 days of follow-up (median = 508 days [IQR = 429−511]). Four distinct PrEP use trajectories were identified: ≤2 tablets per week ("low frequency," 12% of the total population), 4 tablets per week ("variable," 17%), "almost daily" (31%) and "always daily" (41%). Compared to participants with "low frequency" PrEP use, participants with "variable" (odds ratio [OR] = 2.18, 95% confidence interval [CI] = 1.04−4.60) and "almost daily" PrEP use were more often AMPrEP participants (OR = 2.64, 95% CI = 1.27−5.49). "Almost daily" PrEP users were more often employed (OR = 6.76, 95% CI = 2.10−21.75) and were younger compared to participants with "low frequency" PrEP use. In addition, the number of days on which anal sex occurred was lower among participants with "low frequency" PrEP use compared to the other groups (all p<0.001). Compared to "low frequency" PrEP users, the incidence rates of chlamydia and gonorrhoea were higher for participants with "almost daily" and "always daily" PrEP use. Conclusions: We uncovered four distinct PrEP use trajectories, pointing to different patterns of PrEP use in practice beyond the two-regimen dichotomy. These trajectories were related to sexual behaviour and rates of sexually transmitted infection. Tailoring PrEP care according to different PrEP use patterns could be an important strategy to improve efficient PrEP delivery.

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Putting 2-1-1 into Practice: PrEP Users’ Knowledge of Effectively Starting and Stopping Oral PrEP Use

et al. 2022

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Starting and stopping oral HIV pre-exposure prophylaxis (PrEP) in a way that compromises its effectiveness should be avoided. Between September 2020 and June 2021, we assessed self-perceived and actual knowledge of effectively starting and stopping oral PrEP through an online survey among 206 PrEP users assigned male at birth in Belgium. We examined associations between incorrect start-and-stop knowledge and socio-demographics, sexual behaviour and PrEP use, using biand multi-variable logistic regression. The majority of men (84.9%) perceived their start-and-stop knowledge as 'very good', but only 62.1% of all men correctly indicated how to effectively start and stop with PrEP. Using PrEP daily [adjusted OR 2.12, 95% CI (1.06-4.28), p = 0.034] was significantly associated with incorrect start-and-stop knowledge. To enable PrEP users to effectively use PrEP, they need to be better informed about how to start and stop use, irrespective of the dosing regimen.

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Incorrect Knowledge of Event-Driven PrEP “2-1-1” Dosing Regimen Among PrEP-Experienced Gay and Bisexual Men in Australia

Cited by 5 publications

References 40 publications

Increased awareness of event-driven PrEP and knowledge of how to use it: results from a cross-sectional survey of gay and bisexual men in Australia

Increased awareness of event-driven PrEP and knowledge of how to use it: results from a cross-sectional survey of gay and bisexual men in Australia

Trajectories of PrEP use among men who have sex with men: a pooled analysis of two prospective, observational cohort studies

Putting 2-1-1 into Practice: PrEP Users’ Knowledge of Effectively Starting and Stopping Oral PrEP Use

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