What do Dutch MSM think of preexposure prophylaxis to prevent HIV-infection? A cross-sectional study.
OBJECTIVE
Although preexposure prophylaxis (PrEP) is not registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. We aimed to gain insight into PrEP awareness and the intention to use PrEP among MSM.


METHODS
Cross-sectional study among 448 HIV-negative participants of the Amsterdam Cohort Study who completed a questionnaire concerning behavior and PrEP between 2012 and 2013.


METHODS
Characteristics, PrEP awareness, and intention to use PrEP were described and multinomial logistic regression was used to identify determinants of a medium and high intention to use PrEP.


RESULTS
PrEP awareness was 54%, but only 13% reported a high intention to use PrEP. High-risk MSM were more likely to have a medium [adjusted odds ratio (aOR): 1.78 (95% confidence interval [CI] 1.07-2.97)] or high [aOR: 3.92 (95% CI 1.68-9.15)] intention to use PrEP than low-risk MSM, as were MSM with higher perceptions of self-efficacy to use PrEP [high intention: aOR: 6.15 (95% CI 2.50-15.09)] and higher perceptions of relief due to PrEP [medium intention: aOR: 2.67 (95% CI 1.32-5.40); high intention: aOR: 14.87 (95% CI 5.98-37.01)] than MSM with lower perceptions. MSM with higher perceptions of shame about using PrEP [medium intention: aOR: 0.35 (95% CI 0.19-0.62); high intention: aOR: 0.22 (95% CI 0.07-0.71)] or with more worries about side-effects were less likely to have a high [aOR: 0.18 (95% CI 0.06-0.54)] or medium [aOR: 0.29 (95% CI 0.12-0.72)] intention to use PrEP.


CONCLUSIONS
The overall intention to use PrEP was relatively low, but higher among high-risk MSM. If PrEP implementation among high-risk MSM in the Netherlands becomes reality, PrEP awareness should be increased and psychosocial determinants that will influence uptake should be addressed.
aDepartment of Infectious Diseases Research and Prevention, Public Health Service Amsterdam bDepartment of Infectious Diseases, Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), University of Amsterdam cSTI Outpatient Clinic, Public Health Service Amsterdam dDepartment of Dermatology, Academic Medical Center (AMC), University of Amsterdam eDepartment of Infectious Diseases, Public Health Service of Amsterdam fDivision of Infectious Diseases, Department of Internal Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands.
Janneke P
JP
Bil
Udi
U
Davidovich
Wendy M
WM
van der Veldt
Maria
M
Prins
Henry J C
HJ
de Vries
Gerard J B
GJ
Sonder
Ineke G
IG
Stolte
D000328:Adult; D015331:Cohort Studies; D017280:Condoms; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D012725:Sexual Behavior; D011795:Surveys and Questionnaires