Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study.
BACKGROUND
Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design.


METHODS
Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically.


RESULTS
Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use.


CONCLUSIONS
These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities.
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.
Jamie
J
Frankis
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
Ingrid
I
Young
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.
Paul
P
Flowers
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
Lisa
L
McDaid
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001364:Awareness / Q000502:physiology; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D056990:Post-Exposure Prophylaxis; D065129:Pre-Exposure Prophylaxis; D036301:Qualitative Research; D012606:Scotland; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult
D019380:Anti-HIV Agents