Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men

Abstract

HIV prevention method preferences were evaluated among 512 U.S. men who have sex with men (MSM; median age: 22 years). Approximately 90% consistently preferred one option across pairwise comparisons of condoms, daily oral pre-exposure prophylaxis (PrEP), and long-acting PrEP delivered via either an injectable or one of two types of PrEP implants differing in visibility. Condoms were most frequently preferred (33.8%), followed by non-visible implants (21.5%), and oral PrEP (17.0%); HIV risk was reported by more choosing implants. In a follow-up question comparing the four PrEP options only, daily oral pills and non-visible implants were most frequently preferred (35.5% and 34.3%, respectively), followed by injections (25.2%) and visible implants (4.3%). An inductive, open-coding approach determined that convenience, duration of protection, and privacy were the most commonly cited reasons for a PrEP method choice, and associated with self-report of HIV risk. Tailoring PrEP product development to privacy and other concerns important to those at highest HIV risk may improve HIV prevention.

Next-Generation HIV Pre-Exposure Prophylaxis Preferences Among Men Who Have Sex with Men Taking Daily Oral Pre-Exposure Prophylaxis

“…[21][22][23] Some studies have also included RMs and SIs. [24][25][26] Findings from this research suggest that MSM are interested in and willing to use next-generation PrEP formulations and that LAIs are preferred over daily oral PrEP. Few of these studies have compared preferences across modalities, and none have compared all modalities currently in development to daily oral PrEP.…”

Determining the Roles that Club Drugs, Marijuana, and Heavy Drinking Play in PrEP Medication Adherence Among Gay and Bisexual Men: Implications for Treatment and Research

“…6–9 Although recent data indicate a 73% year-over-year increase in PrEP uptake from 2012–2016 in the U.S., 10 fewer than 60,000 males (including men not identifying as GBM) were prescribed PrEP in mid-2017. The trajectory of increasing PrEP uptake could continue to rise as new dosing formulations (e.g., long-acting injectable PrEP) become available based on interest among GBM, 11–13 and alternative dosing may also help increase PrEP persistence and adherence because many (i.e., 31–67%) daily oral PrEP users reported interest or willingness to switch to long-acting injectable PrEP. 14,15 …”

Extended-Duration MK-8591-Eluting Implant as a Candidate for HIV Treatment and Prevention

“…New HIV treatment and prevention interventions that aim to improve adherence by reducing the complexity of regimens, the frequency of the dosages, and/or the side effects of the medications are thus required. Long-acting injectable (LAI) drug formulations that permit less-frequent dosing, on the order of a month or longer, are an increasingly attractive option to address adherence challenges (13)(14)(15)(16). Owing to this potential, the investigational HIV integrase strand transfer inhibitor (InSTI) cabotegravir (GSK1265744; GlaxoSmithKline) has recently advanced into phase 3 clinical studies as a long-acting injectable formulation for PrEP, and the combination of cabotegravir and the nonnucleoside reverse transcriptase inhibitor (NNRTI) rilpivirine (RPV; TMC278LA; Janssen Pharmaceuticals) has recently advanced into phase 3 clinical studies as longacting injectable formulations for HIV treatment maintenance (17)(18)(19)(20)(21).…”