Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year

Abstract

Background: Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year. Methods: A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status. Results: Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP. Conclusion: GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.

Willingness to use HIV pre-exposure prophylaxis and associated factors among men who have sex with men in Liuzhou, China

“…In contrast, MSM who had undergone HIV testing in the past showed a willingness to use PrEP, which was similar to a study conducted in Hong Kong [ 44 ]. In Liuzhou, different social media technologies and on-site campaigns have been used to encourage MSM to visit CDCs, medical institutions and local CBOs to obtain free HIV testing as well as professional counseling from staff during the testing process.…”

Factors Predicting Uptake of Sexually Transmitted Infections Testing among Men Who Have Sex with Men Who Are “Pre-Exposure Prophylaxis Tourists”—An Observational Prospective Cohort Study

“…RP was defined as their lovers or stable boyfriends, while NRP was defined as men who were not their RP, including casual sex partners and male sex workers. SDU was defined as the use of any psychoactive substances (i.e., ketamine, methamphetamine, cocaine, cannabis, ecstasy, Dormicum/Halcion/Erimin 5/non-prescription hypnotic drugs, heroin, codeine from cough suppressants, amyl nitrates (poppers), γ-hydroxybutyrate (G water), and Foxy) before or during sexual intercourse [ 11 , 33 ].…”

“…The coverage of the PrEP demonstration project in Hong Kong was limited, and the cost to obtain PrEP from private clinics is quite high (approximately US $1000 per month) [ 10 ]. MSM in Hong Kong showed demands for PrEP [ 10 , 11 , 12 ]. Due to the high cost, the majority of local MSM PrEP users obtained the medication from overseas clinics or through online purchase [ 10 , 13 ].…”

“…There was a large scale ongoing PrEP project (PrEP30) in Thailand that lasted from December 2014 to January 2021, which had established clinics that provided PrEP to foreigners at US $30 per month [ 25 ]. Given geographic accessibility, its positioning as a tourist location in general, and the low cost for PrEP, Thailand becomes one of the most popular destinations for Hong Kong MSM “PrEP tourists” [ 11 ]. Since most “PrEP tourists” only visit overseas PrEP clinics once, irregularly for refill of PrEP; it is difficult for them to obtain support from such clinics when they are back to Hong Kong.…”

Facilitators and Barriers to Take Up Clinician-Collected and Self-Collected HPV Tests among Chinese Men Who Have Sex with Men

“…Participants also reported sexualized drug use (SDU) in the last six months. SDU is defined as the use of any of the following psychoactive substance before or during sexual intercourse: ketamine, methamphetamine, cocaine, cannabis, ecstasy, Dormicum/Halcion/Erimin 5/non-prescription hypnotic drugs, heroin, cough suppressant (not for curing cough), gamma-hydroxybutyric acid (GHB)/gamma-butyrolactone (GBL), 5-methocy-N, N-diisopropyltryptamine (Foxy), or mephedrone [ 38 , 39 ].…”