title: Awareness and use of nonoccupational post-exposure prophylaxis among men who have sex with men in Vancouver, Canada.
abstract: Nonoccupational post-exposure prophylaxis (nPEP) is a strategy to reduce the risk of HIV infection in those with high-risk exposure. This study characterized nPEP awareness among gay, bisexual and other men who have sex with men (MSM) in Metro Vancouver, British Columbia, Canada after a pilot nPEP programme established in 2012.
  
  
  
  Momentum Health Study participants were MSM aged ≥16 years recruited via respondent-driven sampling (RDS) who completed a computer-assisted self-interview. Stratifying patients by HIV status, we used multivariable logistic regression with backward selection to identify factors associated with nPEP awareness. All analyses were RDS-adjusted.
  
  
  
  A total of 51.9% (112 of 173) of HIV-positive and 48.5% (272 of 500) of HIV-negative participants had heard of nPEP. Only 3% (five of 106) of HIV-negative participants who reported recent high-risk sex used nPEP. Generally, nPEP awareness was higher for participants who engaged in sexual activities with increased HIV transmission potential. Factors associated with greater awareness among HIV-negative participants included recent alcohol use, higher communal sexual altruism, previous sexually transmitted infection diagnosis, and greater perceived condom use self-efficacy. Other factors associated with greater awareness among HIV-negative participants included white race/ethnicity, gay sexual identity, more formal education, lower personal sexual altruism, and Vancouver residence. Greater nPEP awareness among HIV-positive participants was associated with greater perceived agency to ask sexual partners' HIV status and more frequently reporting doing so, a higher number of lifetime receptive sex partners, and greater access to condoms.
  
  
  
  Following implementation of an nPEP pilot programme, nPEP awareness among HIV-negative MSM was 51% and use was 3%. These data support the need to expand access to and actively promote nPEP services.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: S Y
authors.initials: SY
authors.lastname: Lin
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.|Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: N J
authors.initials: NJ
authors.lastname: Lachowsky
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.|Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Hull
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Rich
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: Z
authors.initials: Z
authors.lastname: Cui
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Sereda
authors.affiliation: Health Initiative for Men, Vancouver, BC, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Jollimore
authors.affiliation: Vancouver Coastal Health, Vancouver, BC, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Stephenson
authors.affiliation: Faculty of Nursing, University of British Columbia, Vancouver, BC, Canada.|British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Thumath
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.|Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jsg
authors.initials: J
authors.lastname: Montaner
authors.affiliation: Department of Anthropology, Faculty of Social Sciences, University of Victoria, Victoria, BC, Canada.|Centre for Addictions Research BC, Victoria, BC, Canada.
authors.forename: E A
authors.initials: EA
authors.lastname: Roth
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.|Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
authors.forename: R S
authors.initials: RS
authors.lastname: Hogg
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.|Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.|British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: D M
authors.initials: DM
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D056990:Post-Exposure Prophylaxis / Q000706:statistics & numerical data*; D011446:Prospective Studies; D055815:Young Adult
keywords: HIV/AIDS prevention; clinical health services and promotion; gay and bisexual men; men who have sex with men; nonoccupational post-exposure prophylaxis