Barriers and facilitators in pre-exposure prophylaxis (PrEP) use intention among Chinese homosexual men

Abstract

Abstract Background Despite strengthened efforts on human immunodeficiency virus (HIV) prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China. Pre-exposure prophylaxis (PrEP), a highly effective HIV-prevention tool, has recently been included in China's Action Plan of HIV Prevention and Control. To promote future PrEP implementation, this study aims to identify the barriers and facilitators in PrEP use intention among MSM in China. Methods In 2018, a cross-sectional survey was conducted among 300 MSM in Nanjing, Jiangsu Province. Questions on demographics, sexual behavior (including a seven-item high-risk behavior index), PrEP use intention, PrEP-related awareness and accessibility, and a seven-item public HIV stigma scale were included in the questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP use intention. Results Overall, 44.67% of the participants had more than two male sexual partners and 5.56% had HIV-positive sexual partners. Only 57.00% had heard of PrEP and only four (1.33%) participants had used PrEP. However, 75.34% expressed the willingness to use oral PrEP if its efficacy was assured. The beliefs that “PrEP can prevent HIV if taken as prescribed” (adjusted odds ratio (AOR) = 4.84, P Conclusion Given the low level of awareness of PrEP-related information in China, it's necessary to provide interventions for high-risk individuals and communities, in order to increase their awareness and knowledge of PrEP. Furthermore, additional alternatives to HIV prevention, such as long-acting injectable or implanted PrEP, should be investigated to reduce the risk of HIV infection in at-risk MSM. Even if this programme could be approved by the National Medical Products Administration of China and implemented, a supportive social environment for MSM is essential during its implementing.