PrEP uptake preferences among men who have sex with men in China: results from a National Internet Survey

• Published in: Journal of the International AIDS Society Vol. 22; no. 2; pp. e25242 - n/a
• Main Authors: Han, Jing, Bouey, Jennifer ZH, Wang, Liming, Mi, Guodong, Chen, Zihuang, He, Ying, Viviani, Tara, Zhang, Fujie
• Format: Journal Article
• Language: English
• Published: Switzerland International AIDS Society 01.02.2019; John Wiley & Sons, Inc; John Wiley and Sons Inc
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Age; AIDS; Analysis; Anti-HIV Agents - therapeutic use; Care and treatment; China - epidemiology; Demographics; Disease prevention; Health aspects; Health Knowledge, Attitudes, Practice; Health risk assessment; Health Surveys; HIV; HIV infections; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - psychology; HIV prevention; HIV risk behaviours; Homosexuality, Male - psychology; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Internet; Internet - statistics & numerical data; Male; Middle Aged; MSM (Men who have sex with men); Patient outcomes; Pre-Exposure Prophylaxis; Preferences; PrEP knowledge; PrEP uptake; Prevalence studies (Epidemiology); Questionnaires; Sexual orientation; Surveys and Questionnaires; Unsafe Sex; Young Adult; young Chinese MSM; China; Beijing China; United States > US; HIV risk behaviours; young Chinese MSM; HIV prevention; PrEP knowledge; PrEP uptake
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1002/jia2.25242

Introduction HIV incidence among men who have sex with men (MSM) is high in China. Pre‐exposure prophylaxis (PrEP) is a promising mean to prevent HIV transmission but it is not widely available in China. We conducted a large Internet‐based online survey to assess the willingness of Chinese MSM to take PrEP and associated factors to their uptake preferences. Methods Between 19 January and 6 February, 2017, 4581 MSM aged over 15 years were recruited via a social networking app to take an online PrEP survey. HIV status at the time of the survey being conducted was not one of recruitment criteria. Participants were asked if they had heard of PrEP, if they had concerns about PrEP, and if they would be ready to uptake PrEP should it be provided. When asked if participants were willing to take PrEP, they were asked to select from the following responses: “definitely not,” “probably not,” “not sure,” “probably yes,” and “definitely yes.” In the final analysis, we grouped these five‐level Likert scale responses into three‐level responses as “definitely yes,” “probably yes,” and “no (definitely not/probably not/not sure).” Descriptive analysis and multinomial logistic regressions were conducted to assess the associations of PrEP adoption readiness and uptake concerns with HIV risk behaviours and demographic characteristics. Results MSM from 33 geographical regions of China participated in the survey. The majority were younger than 25 (65.2%) and had attended college (68.6%). HIV prevalence was high (6.8%) and 43.3% reported a history of unprotected anal sex. Only 22.4% of participants had heard of PrEP. When asked if they would uptake PrEP, 26.0% said “definitely yes,” 49.6% were “probably yes,” and 24.4% said “no.” PrEP adoption readiness was associated with having previously heard of PrEP and expressing concerns about accessibility and cost. Worries about side effects, low perceived HIV risk, preference for condoms, and never having received HIV testing were negatively associated with PrEP uptake willingness. Conclusion Young and well‐educated Chinese MSM reported a low willingness to uptake PrEP despite being high‐risk for HIV. Effective education, especially through online mediums, will be critical to optimize this group's PrEP uptake.