Amsterdam 2015
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| Abstract #2290 - PrEP | ||||
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Session: 50.1: PrEP (Symposium) on Friday @ 11.00-12.30 in C103 Chaired by John de Wit, Veronica Noseda Authors: Presenting Author: Ms Janneke Bil - GGD Amsterdam / Public Health Service Amsterdam, Netherlands |
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| Additional Authors: | ||||
| Aim: Pre-exposure prophylaxis (PrEP) is a new biomedical intervention that provides the possibility to prevent HIV-infection in HIV-negative men who have sex with men (MSM). Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the future. Therefore, we aimed to gain insight into the motives for wanting to use PrEP (daily or intermittent) among MSM. | ||||
| Method / Issue: Semi-structured interviews were conducted between February and December 2013 with HIV-negative MSM, recruited through the ongoing Amsterdam Cohort Studies and the internet, until data saturation was reached (N=20). Interviews were transcribed and analyzed using the Grounded Theory approach and results were interpreted using the Health Belief Model and the Social Cognitive Theory. Intermittent use of PrEP was defined as using PrEP from 3 days before until 3 days after a high-risk period of sexual behavior. | ||||
| Results / Comments: Perceived motives for wanting or not wanting to use PrEP in the future could be clustered into personal and environmental motives. Personal motives for wanting to use daily PrEP were: (a) perceived increase in HIV protection resulting in anxiety reduction (b) perceived increase in quality of sex life (c) perceived ease to engage in (sexual) relationships with HIV-positive partners (d) perceived solidarity with HIV-positive partners, and (e) high perceived self-efficacy to adhere to PrEP compared to other risk reductions strategies (e.g., condom use). Personal motives for not wanting to use daily PrEP were: (a) low perceived PrEP efficacy (b) distrust in publications on PrEP efficacy and side-effects (c) low self-perceived HIV-risk (d) preference for other prevention methods (e.g. using condoms, Treatment as Prevention) (e) anticipated PrEP side-effects (f) low perceived self-efficacy to adhere to PrEP and (g) ethical/principle objections against taking PrEP. Environmental motives for not wanting to use daily PrEP were economic costs of PrEP and the anticipated frequency of medical check-ups and counseling involved in using PrEP. Furthermore, sexual network (e.g. having an HIV-positive partner with an undetectable or detectable viral load) influenced motives for future PrEP use. As for intermittent PrEP, men indicated they were skeptic about its use since they were not willing to plan their sex lives or risk episodes. In addition, men expected that intermittent PrEP will decrease their perceived self-efficacy to adhere to other prevention methods (e.g., condom use). On the other hand, men perceived several advantages of using intermittent PrEP compared to the daily use of PrEP, such as reduced costs, reduced number of side effects and the perceived ease of non-daily use. | ||||
| Discussion: Motives for wanting to use PrEP should be taken into consideration when implementing PrEP and developing information campaigns about PrEP. In order to increase the acceptability of PrEP, information campaigns should focus on increasing knowledge about PrEP efficacy, side effects and should address perceived adherence issues. Although, intermittent PrEP seems to have the potential to reduce some of the barriers found for daily PrEP (i.e. reduce economic costs and side-effects), it might only be suitable for men that want and are able to plan their sex life or risk episodes. | ||||
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