Trends in Awareness and Use of HIV PrEP Among Gay, Bisexual, and Other Men who have Sex with Men in Vancouver, Canada 2012–2016
Gay, bisexual, and other men who have sex with men (gbMSM) are at the highest risk for HIV infection in British Columbia (BC). Pre-exposure prophylaxis (PrEP) has been recently licensed but is currently not publicly funded in BC. Using respondent-driven sampling, we recruited a cohort of gbMSM to complete a computer-assisted self-interview with follow-up every 6 months. Stratified by HIV status, we examined trends in awareness of PrEP from 11/2012 to 02/2016 and factors associated with PrEP awareness. 732 participants responded to the PrEP awareness question. Awareness of PrEP among HIV-negative men increased from 18 to 80% (p < 0.0001 for trend); among HIV-positive men, awareness increased from 36 to 77% (p < 0.0001). PrEP awareness was associated with factors related to HIV risk including sero-adaptive strategies and sexual sensation seeking. Eight HIV-negative men reported using PrEP. Low PrEP uptake highlights that PrEP access should be expanded for at-risk gbMSM in BC.
KeywordsHIV/AIDS Pre-exposure prophylaxis Men who have sex with men Primary prevention Longitudinal data
Los hombres que tienen relaciones sexuales con hombres (HSH) están en mayor riesgo de contraer la infección por el VIH en Columbia Británica (BC). La profilaxis previa a la exposición (PrEP) fue recientemente licenciada en Canadá pero actualmente no está financiada públicamente en BC. Usando el muestreo conducido por el encuestado, hemos reclutado una cohorte de HSH para completar una auto-entrevista asistida por ordenador con seguimiento cada seis meses. Estratificado por el estatus de VIH, examinamos las tendencias en el conocimiento de la PrEP de julio de 2012 a febrero de 2016 y los factores asociados con la conciencia de la PrEP. 732 participantes respondieron a la pregunta de sensibilización sobre la PrEP. La proporción de hombres seronegativos que conocían la PrEP aumentó de 18% a 80% (p < 0,0001 para la tendencia); entre los hombres VIH positivos, la conciencia aumentó del 36% al 77% (p < 0,0001). 8 hombres VIH-negativos informaron usar PrEP. La conciencia de PrEP se asoció con factores relacionados con el riesgo de VIH, incluyendo estrategias sero-adaptativas y búsqueda de sensaciones. La baja captación de PrEP destaca que el acceso a la PrEP debería ampliarse para los HSH en riesgo en BC.
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 & 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, 143342, PJT-153139). NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. DMM and NJL are supported by Scholar Awards from the Michael Smith Foundation for Health Research (#5209, #16863). HLA is supported by a Postdoctoral Fellowship Award from the Canadian Institutes of Health Research (Grant # MFE-152443). JM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health (R01DA036307). He has also received limited unrestricted funding, paid to his institution, from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, and ViiV Healthcare.
Momentum is funded through the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes of Health Research (MOP-107544, 143342, PJT-153139).
Compliance with Ethical Standards
Conflict of interest
NJL was 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 and NJL are supported by Scholar Award from the Michael Smith Foundation for Health Research (#5209, #16863). HLA is supported by a Postdoctoral Fellowship Award from the Canadian Institutes of Health Research (Grant # MFE-152443).
Research Involving Human Participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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