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Pre-exposure Prophylaxis Awareness Among Gay and Other Men who have Sex with Men in Vancouver, British Columbia, Canada

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Abstract

Men who have sex with men (MSM) account for approximately half of Canada’s new HIV infections. Pre-exposure prophylaxis (PrEP), a recently established and effective HIV prevention tool for MSM is currently not approved nor publicly funded. We recruited MSM via respondent-driven sampling to complete a self-administered computer-based interview. Stratified by HIV status, multivariable logistic regression identified factors associated with PrEP awareness. Of 673 participants, 102/500 (20.9 %) HIV-negative and 63/173 (26.5 %) HIV-positive men were aware of PrEP, but none had used it. One third of PrEP-aware MSM spoke about it with friends or sex partners. Self-declared knowledge was limited. Factors associated with PrEP awareness varied by HIV status, but included greater HAART optimism for HIV-negative MSM. Among HIV-negative MSM, being PrEP unaware was associated with younger age, not always having condoms, and preferring receptive versus insertive anal sex. Future longitudinal research should identify early adopters of PrEP and its associated impacts.

Resumen

Se estima que aproximadamente la mitad de los nuevos casos de infecciones por VIH en Canadá ocurre en la población de hombres que tienen sexo con hombres (HSH). Aunque la Profilaxis Pre-exposición (PrEP por sus siglas inglés, Pre-exposure prophylaxis), ha demostrado ser una estrategia efectiva para prevenir la infección por VIH, hasta el momento, no cuenta con el apoyo de fondos públicos en Canadá. En este estudio, se reclutaron HSH a través de un método que produce un muestreo dirigido por entrevistados para completar una entrevista auto-administrada por computadora. La población fue estratificada de acuerdo al estado serológico de VIH y se realizó una regresión logística multivariable para identificar factores asociados con el conocimiento de PrEP. De los 673 participantes, 102/500 (20.9 %) de los hombres VIH-negativos y 63/173 (26.5 %) de los VIH-positivos tenían conocimiento acerca del PrEP, pero ninguno lo había usado. Un tercio de los individuos que tenían conocimiento del PrEP, lo habían conversado con amigos o parejas sexuales. Conocimiento reportado por los propios participantes fue mínimo. Los factores asociados con conocimiento del PrEP variaron según el estado serológico de VIH, pero incluyeron mayor optimismo relacionado al HAART entre los HSH VIH-negativos. En este mismo grupo, no tener conocimiento del PrEP fue asociado con una edad mas joven, no siempre tener condones y preferencia por sexo anal receptivo versus insertivo. Los resultados obtenidos en este estudio resaltan la necesidad de que futuros estudios longitudinales identifiquen adoptadores tempranos del PrEP y sus impactos asociados.

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Acknowledgments

The authors would like to thank the Momentum Health Study participants, office staff and community advisory board, as well as our community partner agencies, Health Initiative for Men, YouthCo HIV and Hep C Society, and Positive Living Society of BC. Momentum is funded through the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes for Health Research (MOP-107544). NJL is supported by a CANFAR/CTN Postdoctoral Fellowship Award. JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). JSGM has also received limited unrestricted funding, paid to his institution, from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, and ViiV Healthcare. DMM is supported by a Scholar Award from the Michael Smith Foundation for Health Research (#5209).

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Authors and Affiliations

  1. British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, V6T 1Y6, Canada

    Nathan J. Lachowsky, Sally Y. Lin, Mark W. Hull, Zishan Cui, Paul Sereda, Ashleigh Rich, Julio S. G. Montaner, Robert S. Hogg & David M. Moore

  2. Faculty of Medicine, University of British Columbia, Vancouver, Canada

    Nathan J. Lachowsky, Julio S. G. Montaner & David M. Moore

  3. Health Initiative for Men, Vancouver, Canada

    Jody Jollimore

  4. University of Victoria, Victoria, Canada

    Eric A. Roth

  5. Centre for Addictions Research of British Columbia, Victoria, Canada

    Eric A. Roth

  6. Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada

    Robert S. Hogg

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  1. Nathan J. Lachowsky
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  2. Sally Y. Lin
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Correspondence to Nathan J. Lachowsky.

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Lachowsky, N.J., Lin, S.Y., Hull, M.W. et al. Pre-exposure Prophylaxis Awareness Among Gay and Other Men who have Sex with Men in Vancouver, British Columbia, Canada. AIDS Behav 20, 1408–1422 (2016). https://doi.org/10.1007/s10461-016-1319-8

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