title: Willingness to use HIV pre-exposure prophylaxis and the likelihood of decreased condom use are both associated with unprotected anal intercourse and the perceived likelihood of becoming HIV positive among Australian gay and bisexual men.
abstract: OBJECTIVE
  To investigate willingness to use HIV pre-exposure prophylaxis (PrEP) and the likelihood of decreased condom use among Australian gay and bisexual men.
  
  
  METHODS
  A national, online cross-sectional survey was conducted in April to May 2011. Bivariate relationships were assessed with χ2 or Fisher's exact test. Multivariate logistic regression analysis was performed to assess independent relationships with primary outcome variables.
  
  
  RESULTS
  Responses from 1161 HIV-negative and untested men were analysed. Prior use of antiretroviral drugs as PrEP was rare (n=6). Just over a quarter of the sample (n=327; 28.2%) was classified as willing to use PrEP. Willingness to use PrEP was independently associated with younger age, having anal intercourse with casual partners (protected or unprotected), having fewer concerns about PrEP and perceiving oneself to be at risk of HIV. Among men who were willing to use PrEP (n=327), only 26 men (8.0%) indicated that they would be less likely to use condoms if using PrEP. The likelihood of decreased condom use was independently associated with older age, unprotected anal intercourse with casual partners (UAIC) and perceiving oneself to be at increased risk of HIV.
  
  
  CONCLUSIONS
  The Australian gay and bisexual men the authors surveyed were cautiously optimistic about PrEP. The minority of men who expressed willingness to use PrEP appear to be appropriate candidates, given that they are likely to report UAIC and to perceive themselves to be at risk of HIV.
authors.affiliation: National Centre in HIV Social Research, The University of New South Wales, Sydney NSW 2052, Australia. m.holt@unsw.edu.au
authors.forename: Martin
authors.initials: M
authors.lastname: Holt
authors.forename: Dean A
authors.initials: DA
authors.lastname: Murphy
authors.forename: Denton
authors.initials: D
authors.lastname: Callander
authors.forename: Jeanne
authors.initials: J
authors.lastname: Ellard
authors.forename: Marsha
authors.initials: M
authors.lastname: Rosengarten
authors.forename: Susan C
authors.initials: SC
authors.lastname: Kippax
authors.forename: John B F
authors.initials: JB
authors.lastname: de Wit
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001727:Bisexuality / Q000523:psychology*; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012044:Regression Analysis; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult