Abstract
BackgroundHIV Pre-exposure prophylaxis (PrEP) is being considered for implementation among MSM nationwide in Vietnam. However, there may be concerns about potential obstacles for PrEP adherence among Vietnamese MSM. This study aims to assess the acceptability to use PrEP, potential barriers and facilitators, and the preferences for PrEP service accessibility and delivery among Vietnamese MSM.MethodsFour focus group discussions (FGDs) were conducted with 30 HIV-negative MSM in January 2018 in Hanoi, Vietnam. FGDs explored MSM’s awareness regarding PrEP, perceived benefits and barriers of PrEP use, and willingness to use PrEP. FGDs were audio-recorded and transcribed verbatim. Content analysis was used.ResultsThe mean age of participants was 23.9 years old. Most participants realized the advantages of PrEP given its efficacy in HIV risk reduction and expressed high motivation and interest to use PrEP in the future. PrEP was considered as a supplement alongside condoms. Common concerns about PrEP included side-effects, forgetting to take the pill daily, stigmatization due to using PrEP, negative attitudes toward PrEP from other MSM and accessibility of PrEP. Participants would prefer an injectable PrEP regime if available as it was seen as easier to adhere to. Concerns were also raised that PrEP usage could be interpreted as an indication of engaging in sexual risk behavior for HIV, potentially causing suspicion in love relationships or by family and friends. Participants preferred to receive PrEP in civil business organizations and MSM-friendly clinics, and recommended that pharmacy stores would not be suitable for PrEP implementation due to lack of trust and fear of fake drugs.ConclusionThis study indicated a high level of willingness to use PrEP among MSM in Vietnam in combination with condom. Strategies to raise awareness of PrEP, reduce stigma towards PrEP, and improve the accessibility among MSM in Vietnam is needed. Existing MSM-friendly clinics were recommended to implement PrEP programs in Vietnam.
Highlights
The burden of Human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS) has been increasing in Vietnamese men who have sex with men (MSM) despite a decline achieved in other key populations namely people who inject drugs (PWIDs) and female sex workers (FSW) [1, 2]
This study indicated a high level of willingness to use Pre-exposure prophylaxis (PrEP) among MSM in Vietnam in combination with condom
The burden of HIV/AIDS has been increasing in Vietnamese men who have sex with men (MSM) despite a decline achieved in other key populations namely people who inject drugs (PWIDs) and female sex workers (FSW) [1, 2]
Summary
The burden of HIV/AIDS has been increasing in Vietnamese men who have sex with men (MSM) despite a decline achieved in other key populations namely people who inject drugs (PWIDs) and female sex workers (FSW) [1, 2]. The most recent population-level evidence from Australia indicates that PrEP implementation was associated with a 35% decline in new HIV cases among MSM [19]. This strategy requires an at-risk HIVseronegative MSM to take oral emtricitabine/tenofovir (FTC/TDF) daily, at least four times per week, or to follow the 2-1-1 on-demand regimen to be protected from HIV infection [15, 16, 20, 21]. In addition to oral pills, innovative strategies such as bi-monthly long-acting injectable PrEP (e.g., cabotegravir and rilpivirine) and rectal microbicide gel have been proven in recent years [22,23,24]. This study aims to assess the acceptability to use PrEP, potential barriers and facilitators, and the preferences for PrEP service accessibility and delivery among Vietnamese MSM
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