AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #207 - Knowledge of and attitudes towards pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men in Denver, Colorado
Authors: Presenting Author: Dr. Alia Al-Tayyib - Denver Public Health
Additional Authors: Dr. Mark Thrun,
Aim: Recent results from the Phase III iPrEx efficacy trial of once-daily emtricitabine and tenofovir disoproxil fumarate for pre-exposure prophylaxis (PrEP) in men who have sex with men (MSM) indicate a reduced risk of HIV infection by an average of 44%. Previous surveys of MSM in the United States have shown that PrEP knowledge and use were low, but did not evaluate either willingness to use PrEP should clinical trials show efficacy or intention to change sexual behavior due to PrEP efficacy.
Method / Issue: As part of the 2008 National HIV Behavioral Surveillance (NHBS) MSM cycle in Denver, Colorado, we assessed knowledge of PrEP (“Have you ever heard of PrEP before today?“); willingness to use PrEP if the clinical trials showed few or no side effects, or if the clinical trials showed PrEP to be either 75% or 50% efficacious; reasons why MSM might not use PrEP (including perceived risk for HIV infection, cost, forgetting to take PrEP daily, and stigma); and potential changes in sexual behavior, including intentions to have sex with more partners or use condoms less frequently. Participants who reported being HIV-positive did not receive the PrEP-specific questions.
Results / Comments: Of the 463 participants, 101 (22%) reported being aware of PrEP. If PrEP was found to prevent HIV infection in 75% of people taking PrEP, 271 (58%) participants reported willingness to take PrEP every day while 204 (44%) reported willingness to take PrEP if it was shown to prevent HIV infection in 50% of those taking it. Among the reasons listed for not considering taking PrEP, 223 (48%) had low self-perceived risk for HIV, 221 (48%) were concerned that PrEP would be expensive, 207 (45%) engaged in consistent condom use, 174 (38%) were concerned they might forget to take medication daily, 78 (17%) were not trusting of the investigators, and 45 (10%) were worried what people might think about them if they used PrEP. Overall, 82% reported they did not anticipate any change in condom use and 91% reported no anticipated change in the number of sexual partners if they were to take PrEP.
Discussion: In this sample of MSM in Denver, knowledge of PrEP was low and willingness to use PrEP was dependent on the level of efficacy. Few MSM reported that they would increase their number of sexual partners or decrease condom use as a result of using PrEP. Understanding the attitudes and preferences of persons at risk for HIV infection is needed to help guide the development of prevention strategies that incorporate PrEP use.
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