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HIV Pre-exposure Prophylaxis (PrEP) Uptake Among Gay and Bisexual Men in Australia and Factors Associated With the Nonuse of PrEP Among Eligible Men: Results From a Prospective Cohort Study

Journal of acquired immune deficiency syndromes (1999), 2019-07, Vol.81 (3), p.e73-e84 [Peer Reviewed Journal]

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. ;Copyright Lippincott Williams & Wilkins Ovid Technologies Jul 1, 2019 ;ISSN: 1525-4135 ;EISSN: 1944-7884 ;DOI: 10.1097/QAI.0000000000002047 ;PMID: 30973548

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Title:
HIV Pre-exposure Prophylaxis (PrEP) Uptake Among Gay and Bisexual Men in Australia and Factors Associated With the Nonuse of PrEP Among Eligible Men: Results From a Prospective Cohort Study
Author: Hammoud, Mohamed A ; Vaccher, Stefanie ; Jin, Fengyi ; Bourne, Adam ; Maher, Lisa ; Holt, Martin ; Bavinton, Benjamin R ; Haire, Bridget ; Degenhardt, Louisa ; Grulich, Andrew ; Prestage, Garrett P
Subjects: Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; AIDS/HIV ; Anti-HIV Agents - therapeutic use ; Australia ; Bisexual ; Bisexuality ; Criteria ; Drugs ; Exposure ; Gays & lesbians ; Health risks ; Health Services Accessibility - statistics & numerical data ; HIV ; Homosexuality, Male - psychology ; Homosexuality, Male - statistics & numerical data ; Human immunodeficiency virus ; Humans ; Incidence ; Male ; Middle Aged ; Patient Acceptance of Health Care - psychology ; Patient Acceptance of Health Care - statistics & numerical data ; Poisson density functions ; Pre-Exposure Prophylaxis - statistics & numerical data ; Prophylaxis ; Risk taking ; Sex ; Sexual and Gender Minorities - psychology ; Sexual and Gender Minorities - statistics & numerical data ; Sexually transmitted diseases ; Statistical analysis ; STD ; Young Adult
Is Part Of: Journal of acquired immune deficiency syndromes (1999), 2019-07, Vol.81 (3), p.e73-e84
Description: BACKGROUND:HIV pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention strategy, yet some gay and bisexual men (GBM) who are eligible to access PrEP are not using it. We report the incidence of PrEP uptake, factors predicting its initiation, and identify characteristics associated with nonuptake of PrEP among Australian GBM who meet the eligibility criteria. METHODS:The Following Lives Undergoing Change (Flux) Study is a national, online, prospective observational study among GBM focusing on licit and illicit drug use. Participants (N = 1257) responded to baseline and 6-monthly follow-up questionnaires. Incidence per 100 person-years and incidence rate ratios of PrEP initiation are presented. Multivariate Poisson regression was used to examine associations with PrEP initiation and logistic regression to examine associations with nonuptake of PrEP among eligible GBM. RESULTS:Among GBM who met the eligibility criteria, 69.8% of men did not commence PrEP. Factors independently associated with nonuptake of PrEP were younger age, living in an Australian state without a PrEP trial, lower social engagement with other gay men, less use of illicit party drugs or use of illicit party drugs for sex, and less likely to have engaged in HIV sexual risk behaviors such as group sex or any condomless anal intercourse. CONCLUSIONS:Despite meeting formal eligibility criteria for PrEP, men who were relatively less sexually active or less socially connected were less likely to initiate PrEP. Men who did not initiate PrEP may assess their risk as insufficient relative to others to warrant using PrEP because they engaged in less frequent “risky” behaviors.
Language: English
Identifier: ISSN: 1525-4135
EISSN: 1944-7884
DOI: 10.1097/QAI.0000000000002047
PMID: 30973548
Source: MEDLINE
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HIV Pre-exposure Prophylaxis (PrEP) Uptake Among Gay and Bisexual Men in Australia and Factors Associated With the Nonuse of PrEP Among Eligible Men: Results From a Prospective Cohort Study

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. ;Copyright Lippincott Williams & Wilkins Ovid Technologies Jul 1, 2019 ;ISSN: 1525-4135 ;EISSN: 1944-7884 ;DOI: 10.1097/QAI.0000000000002047 ;PMID: 30973548

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