Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey

Abstract

ObjectiveWe examined willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia.MethodsAn online survey of 990 MSM was conducted between March and April 2016. Eligibility criteria included being biological male, Malaysian citizen, 18 years of age or above, identifying as MSM, and being HIV negative or unknown status. Participants’ demographics, sexual and drug use behaviors, attitudes towards PrEP, and preferences regarding future access to PrEP were collected. Bivariate analysis and logistic regression were performed to determine factors associated with willingness to use PrEP.ResultsFewer than half of participants (44%) knew about PrEP before completing the survey. Overall, 39% of the sample were willing to take PrEP. Multivariate logistic regression indicated that Malay men (AOR: 1.73, 95% CI:1.12, 2.70), having 2 or more male anal sex partners in the past 6 months (AOR: 1.98, 95% CI: 1.29, 3.05), previous knowledge of PrEP (AOR: 1.40, 95%CI: 1.06, 1.86), lack of confidence in practising safer sex (AOR: 1.36, 95% CI: 1.02, 1.81), and having ever paid for sex with a male partner (AOR: 1.39, 95% CI: 1.01, 1.91) were independently associated with greater willingness to use PrEP, while men who identified as heterosexual were less willing to use PrEP (AOR, 0.36, 95% CI: 0.13, 0.97). Majority of participants preferred to access PrEP at affordable cost below 100 Malaysian Ringgit (USD25) per month from community based organisations followed by private or government hospitals.ConclusionsOverall, MSM in Malaysia reported a relatively low level of willingness to use PrEP, although willingness was higher among those previously aware of PrEP. There is a need to provide PrEP at affordable cost, increase demand and awareness of PrEP, and to provide access to this preventative medication via diverse, integrated and tailored sexual health services.

Awareness and willingness to use HIV pre‐exposure prophylaxis among men who have sex with men in low‐ and middle‐income countries: a systematic review and meta‐analysis

“…These 23 studies related to 22 distinct populations. Two Malaysian studies conducted by Lim et al [31] and Bourne et al [32] were linked in that participants of the quantitative study were invited to participate in follow-on qualitative interviews. All of the quantitative studies were cross-sectional surveys.…”

“…Similarly, in these studies, willingness data were generated from HIV-negative participants. The Thai study by Ding et al [36] and the Malaysian study by Lim et al [31] found that a small proportion of their participants were already using PrEP (2.5% and <1%, respectively). Finally, the profile of participants was also influenced by the recruitment strategies of the included studies, including eligibility criteria.…”

“…Most studies were conducted in urban areas. Five studies used internet-based advertisement and recruitment, including Facebook or organizational websites [31,35,38], often in combination with mobile-based social dating applications (such as Grindr) [31] as well as TV and newspaper advertisements [38]. Several studies used face-to-face recruitment, exclusively or in combination with online methods.…”

“…Several studies used face-to-face recruitment, exclusively or in combination with online methods. Five studies sampled participants from service provision sites such as community-based and youth-led non-governmental organizations [31,32,50,52]. Two studies utilized health facilities for recruitment and data collection, including community health clinics [53] and HIV voluntary counselling and testing sites [51].…”

Sharing solutions for a reasoned and evidence-based response: chemsex/party and play among gay and bisexual men

“…In Australian, South-East Asian and North American contexts, mephedrone use appears rare, and use of GHB remains at low levels at present. 4,5 Such differing patterns of use reinforce the need for both local drug monitoring and for harm reduction and sexual health interventions to be tailored to the trends of the local population.…”