Willingness to use long-acting injectable PrEP among HIV- negative/unknown men who have sex with men in China: a national multicenter online survey

Abstract

Background: Men who have sex with men (MSM) are at high risk of HIV acquisition. Long-acting injectable- (LAI-) PrEP, requiring less frequent dosing, is being studied as an alternative method to daily oral HIV PrEP. With the addition of this potential new prevention method, it expands the scope for a wider user choice and is expected to increase the acceptability and uptake of HIV prevention measures. Methods: Participants were recruited from December 2020 to March 2021through banner advertisements on web- and mobile app-based platforms on Blued, a large gay Chinese social media platform. A total of 969 HIV-negative/unknown participants were included in our study. Multivariate logistic regression was used to analyze the factors associated with the willingness to use LAI-PrEP. Results: In total, 969 participants met the inclusion criteria and finished the survey. 19.5% of participants had never tested for HIV, 66.8% of MSM had multiple male partners, and 51.6% of MSM engaged in the condomless sex with their partner. 66.3% of MSM were aware of PrEP, and only 3.9% of MSM had used PrEP before. The willingness to use daily oral PrEP and LAI-PrEP was 76.6% and 74.0%, respectively. MSM with higher education level were less likely to show willingness to use LAI-PrEP (AOR=0.561, 95%CI: 0.375-0.838). Participants who had the history of HIV test (AOR=1.684, 95%CI: 1.109-2.556), had the willingness to use daily oral PrEP (AOR=10.635,95%CI:7.434-15.214), had multiple male sexual partners (AOR=1.332, 95%CI:0.933-1.903), who used rush popper(AOR=1.494, 95%CI:1.047-2.131), and who were aware of PEP (AOR=1.659, 95%CI: 1.019-2.702) were more likely to show willingness to use LAI-PrEP. Conclusions: In our study, the study subjects had moderate awareness and low uptake of PrEP. The willingness to use daily oral PrEP and LAI-PrEP among the participants were both high. Education level, history of HIV test, multiple male sexual partnerships, rush popper use, PrEP awareness and willingness to use daily oral PrEP were factors associated with the willingness to use LAI-PrEP. This study provided some evidence for the further scale-up of PrEP among the MSM population.