title: Sexual Behavior Patterns and PrEP Dosing Preferences in a Large Sample of North American Men Who Have Sex With Men.
abstract: BACKGROUND
  Pre-exposure prophylaxis (PrEP), taken as a single daily coformulated pill containing tenofovir -emtricitabine, is a promising intervention to reduce the likelihood of HIV acquisition in at-risk individuals, including men who have sex with men. Little is known about the acceptability of less than daily, intermittent PrEP regimens.
  
  
  METHODS
  We conducted an online survey of North American men who have sex with men to characterize their sexual frequency and planning behaviors and correlate these with PrEP dosing preferences.
  
  
  RESULTS
  Of the 3217 respondents who completed the survey, 46% reported engaging in unplanned condomless anal intercourse (CAI) at least once in previous 3 months and 8% reported engaging in CAI more than once per week. In multivariable analysis, reporting unplanned CAI was associated with lower educational level, identifying as homosexual/gay as compared with bisexual, being in a monogamous relationship, having a higher self-perceived risk of HIV acquisition, reporting higher income, engaging in CAI more than five times in the last 3 months, and not having visited a health care provider in the previous year. Frequent CAI (>1 time per week) was associated with being younger, identifying as homosexual/gay as compared with bisexual, being in a monogamous relationship, and having a higher self-perceived risk of HIV. Having only planned sex over the last 3 months was associated with a preference for event-based PrEP, whereas having frequent or unplanned CAI was associated with a preference for daily or time-driven PrEP regimens, respectively.
  
  
  CONCLUSIONS
  Our findings suggest that preferences for different PrEP regimens are associated with the sexual frequency and planning behaviors of potential users.
authors.affiliation: *Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA;†Department of Epidemiology, Harvard School of Public Health, Boston, MA;‡Institute for Community Health Promotion, Brown University School of Public Health, Providence, RI;§The Fenway Institute, Fenway Health, Boston, MA;¶Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA;#On-Line Buddies, Cambridge, MA;**Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA; and††Department of Psychology, University of Miami, Coral Gables, FL.
authors.forename: Conor
authors.initials: C
authors.lastname: Stack
authors.forename: Catie
authors.initials: C
authors.lastname: Oldenburg
authors.forename: Matthew
authors.initials: M
authors.lastname: Mimiaga
authors.forename: Steven A
authors.initials: SA
authors.lastname: Elsesser
authors.forename: Douglas
authors.initials: D
authors.lastname: Krakower
authors.forename: David S
authors.initials: DS
authors.lastname: Novak
authors.forename: James E
authors.initials: JE
authors.lastname: Egan
authors.forename: Ronald
authors.initials: R
authors.lastname: Stall
authors.forename: Steve
authors.initials: S
authors.lastname: Safren
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D004522:Educational Status; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D012307:Risk Factors; D012747:Sexual Partners; D014481:United States; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents