Using Online Settings to Identify Gay and Bisexual Men Willing to Take or With Experience Taking PrEP: Implications for Researchers and Providers.

Abstract

Given the ongoing HIV epidemic, it is essential to identify gay and bisexual men who are interested in starting PrEP as well as active PrEP users. We report on online survey data gathered over a 17-month period in 2014-2015 from gay and bisexual men identified through six sources of recruitment (n = 2903): Facebook, a hookup website, two geosocial-sexual networking apps (herein "App 1: Pop-up ads" and "App 2: Banner ads"), and two types of listservs (one focused on general gay nightlife, and one focused on gay sex parties). Willingness to take PrEP were as follows: sex party listservs (71.3%), both apps (69.8%), Facebook (67.6%), hookup website (65.2%), and nightlife listservs (50.5%). Experience having taken PrEP was as follows: sex party listservs (23.4%), App 2: Banner ads (22.5%), nightlife listservs (17.1) Facebook (14.2%), App 1: Pop-up ads (12.4%), and hookup website (2.1%). In multivariable modeling, willingness to go on PrEP was independently associated with being younger, single, a person of color, and having been tested for HIV in the past 12 months. Source of recruitment was largely unassociated with willingness to start PrEP. Number of recent male partners, number of recent condomless anal sex (CAS) events, and when data were collected (i.e., time in months) were not significantly associated with willingness to start PrEP. In multivariable models, experience having taken PrEP was positively associated with sexual identity as gay, number of recent male sex partners, number of recent CAS acts, being tested for HIV in the past 12 months, and time (in months). Experience taking PrEP varied greatly by recruitment source, suggesting both researchers and providers might be well served to utilize digital mediums to effectively identify these individuals; however, should do so with caution as not all digital options may prove fruitful.