Willingness to Take PrEP and Potential for Risk Compensation Among Highly Sexually Active Gay and Bisexual Men.
Once-daily Truvada (Emtricitabine/Tenofovir) as a method of pre-exposure prophylaxis (PrEP) is one of the most promising biomedical interventions to eliminate new HIV infections; however, uptake among gay, bisexual, and other men who have sex with men has been slow amidst growing concern in popular/social media that PrEP use will result in reduced condom use (i.e., risk compensation). We investigated demographic, behavioral, and psychosocial differences in willingness to use PrEP as well as the perceived impact of PrEP on participants' condom use in a sample of 206 highly sexually active HIV-negative gay and bisexual men. Nearly half (46.1 %) said they would be willing to take PrEP if it were provided at no cost. Although men willing to take PrEP (vs. others) reported similar numbers of recent casual male partners (<6 weeks), they had higher odds of recent receptive condomless anal sex (CAS)-i.e., those already at high risk of contracting HIV were more willing to take PrEP. Neither age, race/ethnicity, nor income were associated with willingness to take PrEP, suggesting equal acceptability among subpopulations that are experiencing disparities in HIV incidence. There was limited evidence to suggest men would risk compensate. Only 10 % of men who had not engaged in recent CAS felt that PrEP would result in them starting to have CAS. Men who had not tested for HIV recently were also significantly more likely than others to indicate willingness to take PrEP. Offering PrEP to men who test infrequently may serve to engage them more in routine HIV/STI testing and create a continued dialogue around sexual health between patient and provider in order to prevent HIV infection.
The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA.|Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY), Brooklyn, NY, USA.|CUNY School of Public Health, New York, NY, USA.
Christian
C
Grov
The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA.|Health Psychology and Clinical Science Doctoral Program, The Graduate Center of CUNY, New York, NY, USA.
Thomas H F
TH
Whitfield
The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA.
H Jonathon
HJ
Rendina
The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA.
Ana
A
Ventuneac
The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA. Jeffrey.Parsons@hunter.cuny.edu.|CUNY School of Public Health, New York, NY, USA. Jeffrey.Parsons@hunter.cuny.edu.|Department of Psychology, Hunter College of City University of New York (CUNY), 695 Park Ave, New York, NY, 10065, USA. Jeffrey.Parsons@hunter.cuny.edu.|Health Psychology and Clinical Science Doctoral Program, The Graduate Center of CUNY, New York, NY, USA. Jeffrey.Parsons@hunter.cuny.edu.
Jeffrey T
JT
Parsons
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D001727:Bisexuality; D000069480:Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / Q000008:administration & dosage*; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D065129:Pre-Exposure Prophylaxis; D000072339:Sexual and Gender Minorities; D055815:Young Adult
D019380:Anti-HIV Agents; D000069480:Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
Gay and bisexual men; PrEP; PrEP acceptability; Risk compensation; Truvada