title: Antiretroviral pre-exposure prophylaxis preferences among men who have sex with men in Vietnam: results from a nationwide cross-sectional survey.
abstract: The HIV/AIDS epidemic in Vietnam is concentrated in subgroups of the population, including men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is a viable strategy for HIV prevention, but knowledge about and preferences for PrEP delivery among Vietnamese MSM are not well understood. Methods: In 2015, an online survey was conducted with recruitment via social networking websites for MSM and peer recruitment. A description of daily oral, long-acting injectable, and rectal microbicide formulations of PrEP was provided to participants. Participants were asked about their prior awareness of and interest in PrEP, and ranked their most preferred PrEP modality. Multivariable logistic regression models were used to assess factors associated with having heard of PrEP and preference for each PrEP modality. Results: Of 548 participants who answered demographic and PrEP-related questions, 26.8% had previously heard of PrEP and most (65.7%) endorsed rectal microbicides as their most preferred PrEP delivery modality. Commonly-cited perceived barriers to uptake of PrEP included concern about side-effects, perception about being HIV positive, and family or friends finding out about their sexual behaviour. In multivariable models, older participants less often endorsed rectal microbicides (adjusted odds ratio (AOR) 0.95 per year, 95% confidence interval (CI) 0.91-0.99) and more often endorsed long-acting injectables (AOR 1.08 per year, 95% CI 1.03 to 1.14) as their preferred PrEP modality. Participants who were willing to pay more for PrEP less often endorsed rectal microbicides (AOR 0.81, 95% CI 0.72-0.92) and more often endorsed long-acting injectables (AOR 1.17, 95% CI 1.01-1.35) and daily oral pills (AOR 1.16, 95% CI 1.00-1.35) as their preferred form of PrEP. Conclusions: A variety of PrEP modalities were acceptable to MSM in Vietnam, but low knowledge of PrEP may be a barrier to implementation.
authors.affiliation: The Fenway Institute, Fenway Community Health, 1340 Boylston Street, Boston, MA 02215, USA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.|Corresponding author. Email: ceo242@mail.harvard.edu.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Oldenburg
authors.affiliation: Center for Applied Research on Men and Health, 51-53 Vo Van Tan Street, Ward 6, District 3, Ho Chi Minh City, Vietnam.
authors.forename: Bao
authors.initials: B
authors.lastname: Le
authors.affiliation: Center for Applied Research on Men and Health, 51-53 Vo Van Tan Street, Ward 6, District 3, Ho Chi Minh City, Vietnam.
authors.forename: Hoang Thi
authors.initials: HT
authors.lastname: Huyen
authors.affiliation: Center for Applied Research on Men and Health, 51-53 Vo Van Tan Street, Ward 6, District 3, Ho Chi Minh City, Vietnam.
authors.forename: Dinh Duc
authors.initials: DD
authors.lastname: Thien
authors.affiliation: Center for Applied Research on Men and Health, 51-53 Vo Van Tan Street, Ward 6, District 3, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen Hoang
authors.initials: NH
authors.lastname: Quan
authors.affiliation: The Fenway Institute, Fenway Community Health, 1340 Boylston Street, Boston, MA 02215, USA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Katie B
authors.initials: KB
authors.lastname: Biello
authors.affiliation: Department of Behavioral and Social Sciences and the Rhode Island Public Health Institute, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Nunn
authors.affiliation: Division of Infectious Diseases, The Miriam Hospital, 1125 N Main Street, Providence, RI 02904, USA.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Chan
authors.affiliation: The Fenway Institute, Fenway Community Health, 1340 Boylston Street, Boston, MA 02215, USA.|Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, 300 Brookline Avenue, Boston, MA 02215, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.affiliation: The Fenway Institute, Fenway Community Health, 1340 Boylston Street, Boston, MA 02215, USA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.|Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mimiaga
authors.affiliation: Center for Applied Research on Men and Health, 51-53 Vo Van Tan Street, Ward 6, District 3, Ho Chi Minh City, Vietnam.|SEARCH, Thai Red Cross AIDS Research Centre, 104 Radjumri Road, Bangkok 10330, Thailand.
authors.forename: Donn
authors.initials: D
authors.lastname: Colby