title: Perceptions among Dutch men who have sex with men and their willingness to use rectal microbicides and oral pre-exposure prophylaxis to reduce HIV risk--a preliminary study.
abstract: Oral pre-exposure prophylaxis (PrEP) with antiretroviral (ARV) tablets and topical PrEP or microbicides containing ARV drugs could help to reduce HIV incidence. These methods hold promise for men who have sex with men (MSM) who are at higher risk of acquiring HIV. This mixed-methods study in the Netherlands explored perceptions of MSM and their willingness to use oral PrEP and rectal microbicides (RM) if made available. Recruited through social media (Facebook and Twitter), 108 MSM completed online questionnaires. Seven of them consented to discuss the survey results in semi-structured interviews. Survey participants preferred a RM that could be applied before and after anal intercourse (60.8%) to daily oral PrEP (20.3%). This preference was based on anticipated user friendliness, hypothetically fewer expected adverse events, and perceptions that RM would be less likely to be confused with ARVs for treatment. Those who preferred oral PrEP had stronger beliefs in the effectiveness of pills, perceived its use as easy, and viewed not requiring sexual partner awareness as advantages. No predictive factors were found for the choice of one prevention method over the other. Although Dutch MSM perceive both oral and topical PrEP positively, many barriers exist to the introduction of these products in the Netherlands. These include lack of regulatory approval of oral PrEP, no proven efficacy as yet for RM, and strong HIV stigma within the MSM population. In-depth qualitative research is needed to further explore the perceptions of MSM to inform implementation of programmes should these HIV prevention methods become available.
authors.affiliation: a Amsterdam Institute for Global Health and Development, Department of Global Health, Academic Medical Centre , University of Amsterdbam , Amsterdam , The Netherlands.
authors.forename: Elske
authors.initials: E
authors.lastname: Marra
authors.affiliation: a Amsterdam Institute for Global Health and Development, Department of Global Health, Academic Medical Centre , University of Amsterdbam , Amsterdam , The Netherlands.|b London School of Hygiene and Tropical Medicine , Amsterdam , The Netherlands.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Hankins
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage*; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D054327:Lubricants / Q000737:chemistry; D008297:Male; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010465:Perception; D065129:Pre-Exposure Prophylaxis; D036301:Qualitative Research; D012007:Rectum; D012747:Sexual Partners; D011795:Surveys and Questionnaires
chemical_list: D000890:Anti-Infective Agents; D000998:Antiviral Agents; D054327:Lubricants
keywords: HIV; MSM; pre-exposure prophylaxis; prevention; rectal microbicides