Post-exposure prophylaxis awareness and use among men who have sex with men in London who use geosocial-networking smartphone applications

Abstract

The number of new HIV infections continues to be on the rise in many high-income countries, most notably among men who have sex with men (MSM). Despite recent attention to the use of antiretroviral medications as pre-exposure prophylaxis (PrEP) among MSM, considerably less research has been devoted to examining the awareness and use of post-exposure prophylaxis (PEP). Based on a convenience sample of 179 self-reported HIV-uninfected MSM using a geosocial-networking smartphone application, this study is among the first to examine the awareness and use of PEP and their demographic and behavioral correlates among MSM in London. Most respondents (88.3%) had heard of PEP, where 27.4% reported having used it. In multivariable models, the disclosure of one’s sexual orientation to their general practitioner (Prevalence ratio [PR]: 3.49; 95% confidence interval (CI): 1.14, 10.70; p = .029) and reporting one’s HIV status as negative (rather than unknown) (PR: 11.49; 95% CI: 1.68, 76.92; p = .013) were associated with having heard of PEP; while the recent use of club drugs (PR: 3.02; 95% CI: 1.42, 6.43; p = .004) was associated with having ever used PEP. High awareness and use in this sample suggest that PEP is a valuable risk-reduction strategy that should be capitalized on, be it in addition to or in the absence of PrEP.

HIV non-occupational post-exposure prophylaxis (nPEP) awareness and promotion among five key populations in China: A cross-sectional study

“…This is different from some other studies reporting older age associated with nPEP awareness [19 , 21] . Individuals who did not receive conventional HIV services were less likely to be aware of nPEP, which is consistent with previous studies [27 , 28] . When participants cared less about HIV severity in their populations, they would pay less attention to HIV prevention measures.…”

Prevalence and correlates of depressive symptoms among gay, bisexual and other men who have sex with men in the PROUD randomised clinical trial of HIV pre-exposure prophylaxis

“…The depression prevalence observed in PROUD at month 12 (14.4%) and 24 (14.4%) is comparable to that found in the Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) cross-sectional survey of HIV-negative GBMSM attending GUM services in England, 2013 to 2014 (PHQ-9 ≥10): 12.4% (n=166/1340) and 15.0% (n=122/815) among GBMSM reporting recent sex (with or without a condom) and recent CAS respectively 17. Depression prevalence at annual follow-up visits in PROUD was also broadly similar to other studies of GBMSM in the UK,13–18 although comparison is made difficult due to different study settings and measures of depression, and the fact that people with HIV were included in most studies (table 6). The prevalence of depressive symptoms observed at follow-up in PROUD was almost twice that observed in a random sample of men and women in England (2007/2008); 7% reported PHQ-9 ≥10,27 although socio-demographic differences may confound this comparison.…”

“…A number of UK studies have examined the prevalence of, and factors associated with, depressive symptoms among GBMSM 13–18. In several of these studies however, power to assess associations was limited due to small sample size (<200 GBMSM),13 15 16 and one limitation of the larger studies is that data were not collected on possible psychosocial risk factors (internalised homophobia and IPV) 14 17 18. There is a need to better understand correlates of depression among GBMSM in the UK.…”

Implementation and Access to Pre-exposure Prophylaxis for Human Immunodeficiency Virus by Men Who Have Sex With Men in Europe

“…In 2017, Goedel et al looked into awareness of PEP among MSM in London, using a sample of MSM “using a geosocial-networking smartphone application” (an “app”) ( 49 ). These apps, such as “ Grindr” ( https://www.grindr.com ) currently represent the most common virtual context platform for MSM to meet their sexual partners ( 49 , 50 ), with a Press Release from the company reporting seven years ago having over two million daily users in over 200 different countries and in London the highest number of users in the world ( 49 ). It is acknowledged that “ MSM who use these, or similar apps may often engage in high-risk behaviors where PEP use may be a suitable prevention strategy” ( 49 ).…”

“…These apps, such as “ Grindr” ( https://www.grindr.com ) currently represent the most common virtual context platform for MSM to meet their sexual partners ( 49 , 50 ), with a Press Release from the company reporting seven years ago having over two million daily users in over 200 different countries and in London the highest number of users in the world ( 49 ). It is acknowledged that “ MSM who use these, or similar apps may often engage in high-risk behaviors where PEP use may be a suitable prevention strategy” ( 49 ). In this London-based study, most individuals of a sample of 179 MSN reported having heard of PEP (88.3%) and 27.4% reported having used it ( 49 ).…”