Prepared for PrEP: Preferences for HIV pre-exposure prophylaxis among Chinese men who have sex with men in an online national survey

Huang, Wenting; Wu, Dan; Ong, Jason; Smith, M. Kumi; Yang, Fan; Fu, Hongyun; Tang, Weiming; Tucker, Joseph D.

doi:10.21203/rs.2.11005/v3

Cited by 3 publications

(4 citation statements)

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“…In this cohort that studied oral PrEP preference, uptake, adherence and continuation, nearly half of AGYW preferred oral PrEP to other biomedical prevention methods, but uptake, adherence and PrEP continuation were low. Studies among men who have sex with men (MSM) show that 25–36% prefer oral PrEP to other options, including those in development, that is condoms, LA injectable PrEP and PrEP implants [16, 17]. A review of qualitative data from potential PrEP users, including AGYW, highlights that individual “preference” to use oral PrEP depends on how conveniently it can be incorporated into everyday life [18].…”

Section: Discussionmentioning

confidence: 99%

“…The median (IQR) time on PrEP was 2.52 months. Fifty-five volunteers discontinued PrEP as follows: lost to follow up (17), side effects (12), no longer interested or lower perceived HIV risk (9) and other reasons, for example pill burden, stigma (17). Four of these re-started, therefore, 30 volunteers (37.0%) completed the study on PrEP.…”

Section: Retention Of 265 Agyw Who Were Offered Prep (2019-2020)mentioning

confidence: 99%

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Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

et al. 2022

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Introduction Oral pre‐exposure prophylaxis (PrEP) has been scaled up; however, data from real‐world settings are limited. We studied oral PrEP preference, uptake, adherence and continuation among adolescent girls and young women (AGYW) vulnerable to HIV in sub‐Saharan Africa. Methods We conducted a prospective cohort study among 14‐ to 24‐year‐old AGYW without HIV who were followed for 12 months in Kampala, Uganda. Within at least 14 days of enrolment, they received two education sessions, including demonstrations on five biomedical interventions that are; available (oral PrEP), will be available soon (long‐acting injectable PrEP and anti‐retroviral vaginal ring) and in development (PrEP implant and HIV vaccine). Information included mode and frequency of delivery, potential side effects and method availability. Volunteers ranked interventions, 1 = most preferred to 5 = least preferred. Oral PrEP was “preferred” if ranked among the top two choices. All were offered oral PrEP, and determinants of uptake assessed using Poisson regression with robust error variance. Adherence was assessed using plasma tenofovir levels and self‐reports. Results Between January and October 2019, 532 volunteers were screened; 285 enrolled of whom 265 received two education sessions. Mean age was 20 years (SD±2.2), 92.8% reported paid sex, 20.4% reported ≥10 sexual partners in the past 3 months, 38.5% used hormonal contraceptives, 26.9% had chlamydia, gonorrhoea and/or active syphilis. Of 265 volunteers, 47.6% preferred oral PrEP. Willingness to take PrEP was 90.2%; however, uptake was 30.6% ( n = 81). Following enrolment, 51.9% started PrEP on day 14 (same day PrEP offered), 20.9% within 30 days and 27.2% after 30 days. PrEP uptake was associated with more sexual partners in the past 3 months: 2–9 partners (aRR = 2.36, 95% CI: 1.20–4.63) and ≥10 partners (aRR 4.70, 95% CI 2.41–9.17); oral PrEP preference (aRR 1.53, 95% CI 1.08–2.19) and being separated (aRR 1.55, 95% CI 1.04–2.33). Of 100 samples from 49 volunteers during follow up, 19 had quantifiable tenofovir levels (>10 μg/L) of which only three were protective (>40 μg/L). Conclusions Half of AGYW preferred oral PrEP, uptake and adherence were low, uptake was associated with sexual behavioural risk and oral PrEP preference. Development of alternative biomedical products should be expedited to meet end‐user preferences and, community delivery promoted during restricted movement.

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Section: Discussionmentioning

confidence: 99%

Section: Retention Of 265 Agyw Who Were Offered Prep (2019-2020)mentioning

confidence: 99%

Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

et al. 2022

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“…This demonstrates that expanded PrEP or PEP knowledge dissemination in recent years was effective in increasing relative awareness, yet efforts of promoting the uptake saw little improvement among MSM in China. Previous studies showed that awareness of PrEP was associated with potential PrEP uptake (10,14). Increasing accurate knowledge for PrEP could promote PrEP initiation among MSM in China (12).…”

Section: Discussionmentioning

confidence: 97%

Predictors and Highlights for pre- and post-exposure Prophylaxis Uptake among Men who have sex with Men in three large Cities in China

Wang

Sun

et al. 2022

Preprint

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Background Pre- and post-exposure prophylaxis (PrEP and PEP) haven’t been promoted among Chinese men who have sex with men (MSM) efficiently and nationally. As HIV prevalence among the population is high and increasing, it is urgent to facilitate PrEP and PEP promotion. This study aims to assess predictors for PrEP and PEP uptake and highlights for future promotion among MSM. Methods This cross-sectional study involved MSM in three large cities including Beijing, Shenzhen, and Kunming. We collected data by asking participants to scan a QR code with a cellphone and fill out an online questionnaire, which covers demographic and behavioral characteristics, and PrEP/PEP awareness and uptake. All participants provided online informed consent. The study protocol and informed consent form was approved by the institutional review board of National Center for AIDS/STD Control and Prevention. Results Between March and May 2019, the study enrolled 3,401 MSM. MSM being aware of, having consulted, and having taken PrEP and PEP accounted for 71.6%, 19.5%, 6.0%, 78.0%, 24.6%, and 11.4% respectively. Group sex and illicit drug use were associated with PrEP or PEP uptake. PrEP and PEP uptake was significantly associated with each other. MSM of 16-24 years old non-student were at higher risk of HIV infection and tested for HIV more frequently than other MSM, yet did not have higher PrEP/PEP uptake. Conclusions PrEP or PEP uptake was generally low among MSM in China. Integrating HIV testing, PrEP and PEP as an intervention package might facilitate PrEP/PEP uptake among the population. PrEP/PEP promotion should highlight MSM of 16-24 years old non-student.

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“…Although studies about acceptability from LMIC indicate a preference for long-acting prevention methods generally, these did not specifically consider LA-CAB and its specific logistical considerations for service delivery, which will require more human and financial resources, and will increase costs [39,43,44].…”

Section: Preexposure Prophylaxis Service Delivery Modelsmentioning

confidence: 99%

Long-acting preexposure prophylaxis in low- and middle-income countries: key considerations for implementation

Kaewpoowat

Chariyalertsak

Phanuphak

et al. 2022

Current Opinion in HIV and AIDS

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Purpose of reviewHIV preexposure prophylaxis (PrEP) is a key tool in ending the HIV epidemic. Long-acting cabotegravir (LA- CAB) phase II/III studies revealed promising efficacy in preventing HIV acquisition. Here, we discuss key considerations for implementing LA-CAB in low- and middle-income countries (LMIC).Recent findingsPrEP roll out in LMIC is still far from ideal, and contextual factors within LMIC vary widely. Implementation science studies are urgently needed to optimize the implementation of LA-CAB in different settings, consider effective service delivery models, and ensure program sustainability. Preferences and concerns regarding LA-CAB among potential users are unknown but likely specific to local context. Demedicalized and simplified PrEP service delivery increases uptake, and ways to safely and effectively do the same for LA- CAB need to be explored. Although ideally LA-CAB should be an additional choice of HIV prevention method, its cost will be the major determinant in deciding its position as a first line choice or restricted second-line option.SummaryLA-CAB has the potential to enhance PrEP uptake. However, several implementation challenges need to be explored and addressed to ensure it can be accessed and utilized in different settings by those who need it the most.

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Prepared for PrEP: Preferences for HIV pre-exposure prophylaxis among Chinese men who have sex with men in an online national survey

Cited by 3 publications

References 0 publications

Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

Predictors and Highlights for pre- and post-exposure Prophylaxis Uptake among Men who have sex with Men in three large Cities in China

Long-acting preexposure prophylaxis in low- and middle-income countries: key considerations for implementation

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