PrEP Willingness and Adherence Self-Efficacy Among Men Who have Sex with Men with Recent Condomless Anal Sex in Urban China

• Published in: AIDS and behavior Vol. 25; no. 11; pp. 3482 - 3493
• Main Authors: Sun, Shufang, Yang, Cui, Zaller, Nickolas, Zhang, Zhihua, Zhang, Hongbo, Operario, Don
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.11.2021; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; AIDS; Anal intercourse; Anal sex; Asian cultural groups; China; Disease prevention; Gays & lesbians; Health Psychology; HIV; HIV Infections - prevention & control; Homosexuality, Male; Human immunodeficiency virus; Humans; Infectious Diseases; Male; Medical tests; Medicine; Medicine & Public Health; Men; Men who have sex with men; Mens health; Migrants; Original Paper; Pre-Exposure Prophylaxis; Prevention; Public Health; Self Efficacy; Sexual and Gender Minorities; Sexual Behavior; Sexual Partners; Sexually transmitted diseases; STD; China; PrEP willingness; PrEP; Stigma; China; Men who have sex with men
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-021-03274-0

This study investigates PrEP willingness, adherence self-efficacy and potential impact of PrEP among HIV-negative, Chinese men who have sex with men (MSM; n  = 622) with recent condomless anal sex. Facilitative factors of PrEP willingness included migrant status, sexual risk, and prior PrEP use, whereas barriers included concerns over being treated as an HIV/AIDS patient, recent HIV testing, identity concealment, and HIV prevention service usage. Adherence self-efficacy was associated with PrEP knowledge and confidence in PrEP efficacy of HIV prevention. A total of 39.3% anticipated increase in sex partners, 25.6% anticipated decrease in condom use, and 38.0% anticipated increased HIV testing following PrEP uptake. Results suggest a two-step approach to (1) promote PrEP acceptance among Chinese MSM and (2) enhance adherence and risk monitoring among PrEP-willing MSM. Efforts to reduce stigma, incorporate PrEP in the HIV prevention continuum, and increase PrEP knowledge will be crucial to optimize PrEP implementation.