Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men

Abstract

HIV prevention method preferences were evaluated among 512 U.S. men who have sex with men (MSM; median age: 22 years). Approximately 90 % consistently preferred one option across pairwise comparisons of condoms, daily oral pre-exposure prophylaxis (PrEP), and long-acting PrEP delivered via either an injectable or one of two types of PrEP implants differing in visibility. Condoms were most frequently preferred (33.8 %), followed by non-visible implants (21.5 %), and oral PrEP (17.0 %); HIV risk was reported by more choosing implants. In a follow-up question comparing the four PrEP options only, daily oral pills and non-visible implants were most frequently preferred (35.5 and 34.3 %, respectively), followed by injections (25.2 %) and visible implants (4.3 %). An inductive, open-coding approach determined that convenience, duration of protection, and privacy were the most commonly cited reasons for a PrEP method choice, and associated with self-report of HIV risk. Tailoring PrEP product development to privacy and other concerns important to those at highest HIV risk may improve HIV prevention.

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Acknowledgments

Northwestern University Feinberg School of Medicine and Northwestern Medicine supported this research. The National Institute of Allergy and Infectious Diseases of the National Institutes of Health funded preparation of this manuscript under award number UM1 AI120184. The authors appreciate the Northwestern University infrastructure support provided by the IMPACT LGBT Health and Development Program and the Third Coast Center for AIDS Research, an NIH-funded center (P30 AI 117943). This research could not have been conducted without research staff support from Antonia Clifford, Krystal Madkins, and Dan Ryan. We also appreciate expert marketing consulting advice from Robert Schieffer and critical manuscript review by Rebecca Giguere.

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Correspondence to Richard T. D’Aquila.

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Greene, G.J., Swann, G., Fought, A.J. et al. Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men. AIDS Behav 21, 1336–1349 (2017). https://doi.org/10.1007/s10461-016-1565-9

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Keywords

  • HIV
  • Homosexuality
  • Male
  • Pre-exposure prophylaxis
  • Prevention
  • Sexual behavior