Risk-Taking Behaviors and Adherence to HIV Pre-Exposure Prophylaxis in Users of Geosocial Networking Apps: Real-Word, Multicenter Study (Preprint)

Abstract

BACKGROUND With the surge of geosocial networking app (GSN) dating, GSN users have become a unique large subpopulation among men who have sex with men (MSM) concerning HIV prevention and control. OBJECTIVE This study revealed the impact of GSN use on medication adherence among MSM receiving pre-exposure prophylaxis (PrEP), aiming to provide enlightenment to address the widespread improvement of adherence. METHODS This study based on the China Real-world Oral intake of PrEP (CROPrEP) project, a multicenter, real-world study of Chinese MSM attending daily and event-driven PrEP. Eligible participants completed a detailed computer-assisted self-interview (CASI) on sociodemographics, GSN use, and sexual behavior. Then participants were followed up for 12 months (e.g., PrEP delivery, adherence assessment, PrEP coverage of sex activities, and regimens switch). A generalized estimation equation was used to analyze the predictors of medication adherence and regimen conversion among GSN users and non-users. RESULTS At baseline, 74% of the 1,023 eligible participants, reported primarily using GSN to seek sexual partners, and GSN users are more likely to have high-risk behaviors such as multiple sex partners and condomless than other non-users (all p<.05). During follow-up, GSN-users have a significantly low level of pill-counting adherence than non-users (adjusted odds ratio [aOR]=.8, 95%CI=.6~1.0, p =.038). At event-driven group, GSN users had marginal lower levels of self-reported adherence (aOR=.7, p=.060) and lower PrEP coverage of sex practices (aOR=.6, p=.038). Additionally, GSN users seemed more likely to switch from event-driven to daily regimen (aOR=1.8, p=.084). CONCLUSIONS GSN users are highly prevalent in MSM, despite their higher sexual risk, lower adherence levels, suggesting that eHealth needs to be introduced to the GSN platform to promote PrEP adherence. CLINICALTRIAL ChiCTR-IIN-17013762.