Knowledge, Attitudes and Practices Regarding Pre-Exposure Prophylaxis (PrEP) in a Sample of Italian Men Who Have SEX with MEN (MSM)

Abstract

Background: Pre-exposure prophylaxis (PrEP) is suitable for high human immunodeficiency virus (HIV)-infection risk people, foremost among whom are males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. No previous study has assessed this issue; Methods: An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour and habits, HIV/acquired immune deficiency syndrome (AIDS) knowledge and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify factors associated with PrEP knowledge; Results: A total of 196 MSM participated in this survey. Overall data showed that 87.2% of participants knew what PrEP is, but only 7.5% have ever used it. The main reason for not using PrEP was the cost of the therapy (26.9%). The principal source of PrEP information was the Internet (68.4%). Being regularly tested for HIV was significantly associated with PrEP knowledge (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06–9.29); Conclusions: Knowledge regarding PrEP was well established, but PrEP use was not equally widespread. It is necessary to improve research on PrEP usage in order to PrEP access to be granted.

Multi-dimensional mismatch and barriers for promoting PrEP among men who have sex with men in China: a cross sectional survey from the Demand-side

“…Still, affordability held a key barrier against a final decision to initiate PrEP in our study, which was coherent with previous reports [ 26 , 35 , 36 ]. The participants reported high initial willingness to use PrEP (when it was free) but low pay willingness, and this discrepancy might be consequence of PrEP cost and affordability.…”

Multi-dimensional mismatch and barriers for promoting PrEP among men who have sex with men in China: a cross sectional survey from the Demand-side

“…Still, affordability holds a key barrier against a nal decision to initiate PrEP in our study, which is coherent with previous reports [26,35,36] .Participants reported a high initial willingness to use PrEP (when it was free) but a low pay willingness, and this discrepancy might be a consequence of PrEP cost and affordability. More than three quarters of participants (84.4%) selected that they should have taken PrEP, if cost were not a factor.…”

Oral Pre-exposure Prophylaxis Uptake and Acceptability Among Men Who Have Sex With Men: A Scoping Review of the Literature

“…Negative attitudes from health care workers (Adeagbo et al, 2021;Graham et al, 2023;Holloway et al, 2017;Patrick et al, 2019) Lack of confidentiality by health care providers (Graham et al, 2023) Mistrust of health system and pharmaceutical companies (Adeagbo et al, 2021;Chakrapani et al, 2015;Holloway et al, 2017;Liu et al, 2017;Philbin et al, 2016) Uncomfortable talking about sexuality or PrEP with health care providers (Holloway et al, 2017;Patrick et al, 2019;Yu et al, 2021) Not accessible or inadequate coverage (Blair et al, 2022;Han et al, 2019;Harawa et al, 2016;Holloway et al, 2017;Kota et al, 2021;Patrick et al, 2019;Pichon et al, 2022) Cost / high pricing of PrEP (Chakrapani et al, 2015;Dean et al, 2023;Emmanuel et al, 2020;Galea et al, 2011;Graham et al, 2023;Gredig et al, 2016;Han et al, 2019;Harawa et al, 2016;Hojilla et al, 2018;Holloway et al, 2017;Kota et al, 2021;Mansergh et al, 2012;Patrick et al, 2019;Pérez-Figueroa et al, 2015;Voglino et al, 2021) Restrictive and complex procedure for drug procurement (Ahouada et al, 2020;Diabaté et al, 2021;Liu et al, 2017) Long distance to PrEP facilities (transport cost)…”

“…Pill-related factors Concern about daily pill taking (Galea et al, 2011;Graham et al, 2023;Grant et al, 2014;Holloway et al, 2017;Klein & Washington, 2020;Pelletier et al, 2019;Pingel et al, 2017) Same packaging of PrEP as ART (Graham et al, 2023) Pill size, taste, odor (Diabaté et al, 2021;Pelletier et al, 2019) Effectiveness, safety, and side effects Perceiving PrEP to be ineffective and its inefficacy (Cox et al, 2021;Diabaté et al, 2021;Graham et al, 2023;Gredig et al, 2016) Fear of side effects (Arnold-Forster et al, 2022;Bekker et al, 2022;Blair et al, 2022;Dean et al, 2023;Diabaté et al, 2021;Emmanuel et al, 2020;Graham et al, 2023;Grant et al, 2014;Gredig et al, 2016;Han et al, 2019;Holloway et al, 2017;Klein & Washington, 2020;Kota et al, 2021;Liu et al, 2017;Patrick et al, 2019;Pelletier et al, 2019;Philbin et al, 2016;Voglino et al, 2021;Yu et al, 2021) Possible drug interactions with medications the person already takes (Emmanuel et al, 2020;Klein & Washington, 2020) Risk Perception Low-risk perception (Blair et al, 2022;Chakrapani et al, 2015;Cox et al, 2021;Emmanuel et al, 2020;Graham et al, 2023;…”