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AIDS and Behavior

, Volume 23, Issue 7, pp 1974–1983 | Cite as

Awareness and Perceived Effectiveness of HIV Treatment as Prevention Among Men Who Have Sex with Men in New York City

  • Karolynn SiegelEmail author
  • Étienne Meunier
Original Paper

Abstract

To assess perceptions of HIV treatment as prevention (TasP), we conducted an online survey of MSM in New York City (n = 732) asking them to rate the effectiveness of different strategies to reduce HIV risk during serodiscordant condomless anal sex between men. Only 6.1% reported not knowing what TasP was, with significantly less awareness among non-gay-identified MSM, men with less education, men who reported fewer anal sex partners in the prior 3 months, and HIV-negative/unaware men who had never used PrEP. The strategy most frequently perceived to offer “a lot” or “complete” protection from HIV was daily PrEP (70.0%), followed by TasP (39.1%), intermittent PrEP (16.6%), strategic positioning (15.8%), and withdrawal before ejaculation (10.8%). Men who were HIV positive, who had ever used PrEP, and who identified as gay/homosexual were significantly more likely to see TasP as effective. Further studies should investigate MSM’s apparent skepticism towards TasP.

Keywords

Treatment as prevention (TasP) Men who have sex with men (MSM) HIV prevention Perceived effectiveness Pre-exposure prophylaxis (PrEP) 

Notes

Compliance with Ethical Standards

Conflict of interest

Karolynn Siegel declares that she has not conflict of interest. Étienne Meunier declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    McFarland W, Chen Y-H, Nguyen B, et al. Behavior, intention or chance? A longitudinal study of HIV seroadaptive behaviors, abstinence and condom use. AIDS Behav. 2012;16(1):121–31.CrossRefGoogle Scholar
  2. 2.
    Parsons JT, Schrimshaw EW, Wolitski RJ, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. AIDS. 2005;19(Suppl 1):S13–25.CrossRefGoogle Scholar
  3. 3.
    Jin F, Prestage GP, Mao L, et al. “Any condomless anal intercourse” is no longer an accurate measure of HIV sexual risk behavior in gay and other men who have sex with men. Front Immunol. 2015;6:86.CrossRefGoogle Scholar
  4. 4.
    Prestage G, Mao L, Kippax S, et al. Use of viral load to negotiate condom use among gay men in Sydney, Australia. AIDS Behav. 2009;13(4):645.CrossRefGoogle Scholar
  5. 5.
    Stolte IG, de Wit JBF, van Eeden A, Coutinho RA, Dukers NHTM. Perceived viral load, but not actual HIV-1-RNA load, is associated with sexual risk behaviour among HIV-infected homosexual men. AIDS. 2004;18(14):1943–9.CrossRefGoogle Scholar
  6. 6.
    Vernazza P, Hirschel B, Bernasconi E, Flepp M. Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitement antirétroviral efficace ne transmettent pas le VIH par voie sexuelle. Bull Méd Suisses. 2008;89(05):165–9.CrossRefGoogle Scholar
  7. 7.
    Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.CrossRefGoogle Scholar
  8. 8.
    Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016;316(2):171–81.CrossRefGoogle Scholar
  9. 9.
    Bavinton BR, Pinto AN, Phanuphak N, et al. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV. 2018;5(8):e438–47.CrossRefGoogle Scholar
  10. 10.
    Centers for Disease Control and Prevention, National Center for HIV/AIDS, viral hepatitis, STD, and TB prevention. Evidence of HIV treatment and viral suppression in preventing the sexual transmission of HIV [Internet]. Atlanta, GA; 2018 Aug, p. 5. https://www.cdc.gov/hiv/pdf/risk/art/cdc-hiv-art-viral-suppression.pdf. Accessed 18 Sep 2018.
  11. 11.
    Goodenow MM. Why is U = U a game changer? [Internet]. Office of AIDS Research: National Institutes of Health. 2018. https://mailchi.mp/od.nih.gov/letter-from-the-oar-director?e=9841b11756. Accessed 27 Sep 2018.
  12. 12.
    U = U | Prevention Access Campaign [Internet]. https://www.preventionaccess.org. Accessed 27 Sep 2018.
  13. 13.
    HIV Undetectable = Untransmittable (U = U) [Internet]. NYC Department of Health and Mental Hygiene. 2017. https://www1.nyc.gov/site/doh/health/health-topics/hiv-u-u.page. Accessed 17 Sep 2018.
  14. 14.
    Carter A, Lachowsky N, Rich A, et al. Gay and bisexual men’s awareness and knowledge of treatment as prevention: findings from the Momentum Health Study in Vancouver, Canada. J Int AIDS Soc. 2015;18(1):20039.CrossRefGoogle Scholar
  15. 15.
    Prati G, Zani B, Pietrantoni L, et al. PEP and TasP awareness among Italian MSM, PLWHA, and high-risk heterosexuals and demographic, behavioral, and social correlates. PLoS ONE. 2016;11(6):e0157339.CrossRefGoogle Scholar
  16. 16.
    Rendina HJ, Parsons JT. Factors associated with perceived accuracy of the Undetectable = Untransmittable slogan among men who have sex with men: Implications for messaging scale-up and implementation. J Intern AIDS Soc. 2018;1(21):e25055.CrossRefGoogle Scholar
  17. 17.
    Holt M, Lea T, Schmidt H-M, et al. Increasing belief in the effectiveness of HIV treatment as prevention: results of repeated, National Surveys of Australian Gay and Bisexual Men, 2013–15. AIDS Behav. 2016;20(7):1564–71.CrossRefGoogle Scholar
  18. 18.
    Bavinton BR, Holt M, Grulich AE, Brown G, Zablotska IB, Prestage GP. Willingness to act upon beliefs about ‘treatment as prevention’ among Australian gay and bisexual men. PLoS ONE. 2016;11(1):e0145847.CrossRefGoogle Scholar
  19. 19.
    Card KG, Armstrong HL, Lachowsky NJ, et al. Belief in treatment as prevention and its relationship to HIV status and behavioral risk. J Acquir Immune Defic Syndr. 2018;77(1):8.Google Scholar
  20. 20.
    Holt M, Draper BL, Pedrana AE, Wilkinson AL, Stoové M. Comfort relying on HIV pre-exposure prophylaxis and treatment as prevention for condomless sex: results of an online survey of australian gay and bisexual men. AIDS Behav [Internet]. 2018 Mar 21.  https://doi.org/10.1007/s10461-018-2097-2. Accessed 28 Aug 2018.
  21. 21.
    Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral hepatitis, STD, and TB prevention. Pre-exposure prophylaxis (PrEP) for HIV prevention [Internet]. 2014 May. https://www.cdc.gov/hiv/pdf/PrEP_fact_sheet_final.pdf. Accessed 26 Sep 2018.
  22. 22.
    Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Condoms and STDs: fact sheet for public health personnel [Internet]. Atlanta, GA; 2013 Mar, p. 3. http://www.cdc.gov/condomeffectiveness/latex.html. Accessed 29 Nov 2018.
  23. 23.
    Philpot SP, Prestage G, Ellard J, Grulich AE, Bavinton BR. For the opposites attract study group. How do gay serodiscordant couples in Sydney, Australia negotiate undetectable viral load for HIV prevention? AIDS Behav. 2018;22(12):3981–90.CrossRefGoogle Scholar
  24. 24.
    Persson A. ‘The world has changed’: pharmaceutical citizenship and the reimagining of serodiscordant sexuality among couples with mixed HIV status in Australia. Sociol Health Illn. 2016;38(3):380–95.CrossRefGoogle Scholar
  25. 25.
    Vallabhaneni S, Li X, Vittinghoff E, Donnell D, Pilcher CD, Buchbinder SP. Seroadaptive practices: association with HIV acquisition among HIV-negative men who have sex with men. PLoS ONE. 2012;7(10):e45718.CrossRefGoogle Scholar
  26. 26.
    Molina J-M, Capitant C, Spire B, et al. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373(23):2237–46.CrossRefGoogle Scholar
  27. 27.
    Molina J-M, Ghosn J, Béniguel L, et al. Incidence of HIV-infection in the ANRS prevenir study in Paris region with daily or on-demand PrEP with TDF/FTC. J Int AIDS Soc. 2018;21:160.Google Scholar
  28. 28.
    Beymer MR, Gildner JL, Holloway IW, Landovitz RJ. Acceptability of injectable and on-demand pre-exposure prophylaxis among an online sample of young men who have sex with men in California. LGBT Health. 2018;5(6):341–9.CrossRefGoogle Scholar
  29. 29.
    Elsesser SA, Oldenburg CE, Biello KB, et al. Seasons of risk: anticipated behavior on vacation and interest in episodic antiretroviral pre-exposure prophylaxis (PrEP) among a large national sample of U.S. men who have sex with men (MSM). AIDS Behav. 2016;20(7):1400–7.CrossRefGoogle Scholar
  30. 30.
    Newman CE, de Wit J, Persson A, et al. Understanding concerns about treatment-as-prevention among people with HIV who are not Using Antiretroviral Therapy. AIDS Behav. 2015;19(5):821–31.CrossRefGoogle Scholar
  31. 31.
    Grov C, Rendina HJ, Patel VV, Kelvin E, Anastos K, Parsons JT. Prevalence of and factors associated with the use of hiv serosorting and other biomedical prevention strategies among men who have sex with men in a US Nationwide Survey. AIDS Behav. 2018;22(8):2743–55.CrossRefGoogle Scholar
  32. 32.
    Newcomb ME, Mongrella MC, Weis B, McMillen SJ, Mustanski B. Partner disclosure of PrEP use and undetectable viral load on geosocial networking apps: frequency of disclosure and decisions about condomless sex. J Acquir Immune Defic Syndr. 2016;71(2):200–6.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Sociomedical Sciences, Mailman School of Public HealthColumbia University Medical CenterNew YorkUSA

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