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Sex Health. 2019 Apr;16(2):180-186. doi: 10.1071/SH18115.

Community awareness of, use of and attitudes towards HIV pre-exposure prophylaxis (PrEP) among men who have sex with men in Vancouver, Canada: preparing health promotion for a publicly funded PrEP program.

Author information

1
British Columbia Centre for Excellence in HIV/AIDS, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; and School of Public Health & Social Policy, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada; and Corresponding author. Email: nlachowsky@cfenet.ubc.ca.
2
School of Public Health & Social Policy, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
3
British Columbia Centre for Excellence in HIV/AIDS, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
4
Health Initiative for Men, 310-1033 Davie Street, Vancouver, BC V6E 1M7, Canada.
5
British Columbia Centre for Excellence in HIV/AIDS, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; and Faculty of Medicine, University of British Columbia, 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada.

Abstract

Background HIV rates are persistently disproportionate among men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, now publicly funded in British Columbia. This study assessed PrEP-related attitudes, sexual behaviour and self-reported use before public funding.

METHODS:

Adult MSM were recruited from January to June 2017 through a local community-based organisation's PrEP campaign website (www.getpreped.ca). Participants self-completed an anonymous online questionnaire, and were stratified into three groups: (i) HIV-positive participants; (ii) HIV-negative participants not using PrEP; and (iii) HIV-negative participants using PrEP. Descriptive, bivariate and univariate regression analyses were conducted.

RESULTS:

Of 249 participants, 191 (77%) were HIV-negative not using PrEP, 41 (17%) were HIV-negative using PrEP and 17 (7%) were HIV-positive. Among PrEP users, 90% used PrEP daily and all reported having recommended medical follow-up care. Among HIV-negative, non-PrEP-users, 44% said they would reduce condom use if they used PrEP and 28% were uncomfortable asking their doctor for PrEP. Interest in PrEP among non-users was associated with higher objective risk scores (i.e. HIV Incidence Risk Index for MSM), higher self-perceived risk, greater perceived PrEP effectiveness, no prescription medications insurance, open or single relationship status (vs closed) and not always using condoms (vs always). Among HIV-positive participants, 53% agreed PrEP reduced stigma for people living with HIV. All study groups perceived a greater percentage of MSM on PrEP (10%, 15%, 18%) than in their own social networks (5%, 4%, 6%).

CONCLUSIONS:

PrEP health promotion must consider comprehensive PrEP education; accuracy of self-perceived HIV risk and PrEP social norms; and barriers to culturally safe primary care for MSM.

PMID:
31040001
DOI:
10.1071/SH18115

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