PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019.
Bisexual
Gay
HIV
HIV pre-exposure prophylaxis
MSM
Men who have sex with men
PrEP
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
03 06 2022
03 06 2022
Historique:
received:
25
01
2022
accepted:
12
05
2022
entrez:
6
6
2022
pubmed:
7
6
2022
medline:
9
6
2022
Statut:
epublish
Résumé
Access to prevention options, including HIV pre-exposure prophylaxis (PrEP), remains a public health priority for gay, bisexual, and other men who have sex with men (MSM), especially in London. We describe PrEP use in a London community sample of MSM before the introduction of a national PrEP programme in October 2020. From June-August 2019, MSM aged ≥ 18 recruited from London commercial venues were asked to self-complete a sexual health questionnaire and provide an oral fluid sample for anonymous HIV antibody testing. Descriptive analyses of demographic characteristics, service engagement and outcomes, as well as sexual risk and prevention behaviours were examined in the survey population and in those reporting current PrEP use. We performed sequential, multivariate analyses examining current PrEP use in MSM of self-perceived HIV-negative/unknown status with identified PrEP-need defined as the report of condomless anal sex (CAS) in the last three months, or the report of CAS (in the last year) with an HIV-positive/unknown status partner not known to be on HIV treatment, in reflection of UK PrEP guidelines. One thousand five hundred and thirty-fifth questionnaires were completed across 34 venues, where 1408 were analysed. One in five MSM of self-perceived HIV-negative/unknown status reported current PrEP use (19.7%, 242/1230). In men with PrEP-need, 68.2% (431/632) did not report current use. Current PrEP use was associated with age (aOR: 3.52, 95% CI: 1.76-7.02 in men aged 40-44 vs men aged 18-25) and education (aOR: 1.72, 95% CI: 1.01-2.92 in men with ≥ 2 years/still full-time vs no/ < 2 years of education since age 16). Among MSM in London, PrEP use is high but there is indication of unmet PrEP-need in men of younger age and lower levels of post-16 education. National programme monitoring and evaluation will require continued community monitoring to guide interventions ensuring equitable PrEP access and uptake in those who could most benefit from PrEP.
Sections du résumé
BACKGROUND
Access to prevention options, including HIV pre-exposure prophylaxis (PrEP), remains a public health priority for gay, bisexual, and other men who have sex with men (MSM), especially in London. We describe PrEP use in a London community sample of MSM before the introduction of a national PrEP programme in October 2020.
METHODS
From June-August 2019, MSM aged ≥ 18 recruited from London commercial venues were asked to self-complete a sexual health questionnaire and provide an oral fluid sample for anonymous HIV antibody testing. Descriptive analyses of demographic characteristics, service engagement and outcomes, as well as sexual risk and prevention behaviours were examined in the survey population and in those reporting current PrEP use. We performed sequential, multivariate analyses examining current PrEP use in MSM of self-perceived HIV-negative/unknown status with identified PrEP-need defined as the report of condomless anal sex (CAS) in the last three months, or the report of CAS (in the last year) with an HIV-positive/unknown status partner not known to be on HIV treatment, in reflection of UK PrEP guidelines.
RESULTS
One thousand five hundred and thirty-fifth questionnaires were completed across 34 venues, where 1408 were analysed. One in five MSM of self-perceived HIV-negative/unknown status reported current PrEP use (19.7%, 242/1230). In men with PrEP-need, 68.2% (431/632) did not report current use. Current PrEP use was associated with age (aOR: 3.52, 95% CI: 1.76-7.02 in men aged 40-44 vs men aged 18-25) and education (aOR: 1.72, 95% CI: 1.01-2.92 in men with ≥ 2 years/still full-time vs no/ < 2 years of education since age 16).
CONCLUSION
Among MSM in London, PrEP use is high but there is indication of unmet PrEP-need in men of younger age and lower levels of post-16 education. National programme monitoring and evaluation will require continued community monitoring to guide interventions ensuring equitable PrEP access and uptake in those who could most benefit from PrEP.
Identifiants
pubmed: 35659209
doi: 10.1186/s12889-022-13425-0
pii: 10.1186/s12889-022-13425-0
pmc: PMC9163522
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1105Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© 2022. The Author(s).
Références
J Int AIDS Soc. 2019 Dec;22(12):e25419
pubmed: 31850686
Lancet HIV. 2017 Sep;4(9):e402-e410
pubmed: 28747274
Lancet HIV. 2018 Nov;5(11):e629-e637
pubmed: 30343026
AIDS. 2016 Mar 27;30(6):943-52
pubmed: 26963528
AIDS Behav. 2022 Aug;26(8):2768-2782
pubmed: 35182281
Euro Surveill. 2014 Dec 04;19(48):20981
pubmed: 25496573
Lancet. 2016 Jan 2;387(10013):53-60
pubmed: 26364263
AIDS Care. 2020 May;32(sup2):47-56
pubmed: 32189518
Euro Surveill. 2019 Oct;24(41):
pubmed: 31615599
JAMA Netw Open. 2020 Dec 1;3(12):e2030806
pubmed: 33355675
JAMA. 2019 Apr 9;321(14):1380-1390
pubmed: 30964528
Euro Surveill. 2019 Nov;24(48):
pubmed: 31796157
Lancet HIV. 2021 Jul;8(7):e440-e448
pubmed: 34118196
Lancet HIV. 2019 Jul;6(7):e447-e455
pubmed: 31178284
Euro Surveill. 2021 Jun;26(23):
pubmed: 34114539
AIDS Behav. 2019 Feb;23(2):548-555
pubmed: 30117076
Clin Infect Dis. 2017 Jun 15;64(12):1663-1669
pubmed: 28369309
Euro Surveill. 2019 Jun;24(25):
pubmed: 31241039
Sex Transm Infect. 2019 Nov;95(7):484-487
pubmed: 31010953
AIDS. 2017 Sep 10;31(14):2007-2016
pubmed: 28692542
Lancet HIV. 2016 Sep;3(9):e431-e440
pubmed: 27562744
Sex Transm Infect. 2019 Jun;95(4):262-266
pubmed: 30833366
J Health Psychol. 2021 Sep;26(10):1575-1586
pubmed: 31647330
Lancet Public Health. 2020 Sep;5(9):e501-e511
pubmed: 32888443
Lancet HIV. 2020 Feb;7(2):e84
pubmed: 32027853
Sex Transm Infect. 2021 Sep;97(6):429-433
pubmed: 33082235
AIDS. 2022 Mar 15;36(4):561-566
pubmed: 34873084
AIDS. 2021 Mar 15;35(4):665-673
pubmed: 33290298
HIV Med. 2019 Mar;20 Suppl 2:s2-s80
pubmed: 30869189
Lancet HIV. 2020 Feb;7(2):e113-e120
pubmed: 31784343