Risk Behavior Not Associated with Self-Perception of PrEP Candidacy: Implications for Designing PrEP Services
In a study of sexually-active HIV-negative men who have sex with men (MSM) in China, we compared behavioral indication for pre-exposure prophylaxis (PrEP) based on risk criteria to self-perception of PrEP candidacy (SPC) and explored factors associated with SPC. Of 708 MSM surveyed, 323 (45.6%) were behaviorally-indicated for PrEP, among whom 42.1% self-perceived as appropriate PrEP candidates. In a multivariable model we found no association between sexual behavior nor HIV risk perception and SPC but found that higher perceived benefits of PrEP, increased frequency of HIV testing, and low condom use self-efficacy were positively-associated with SPC. In a sub-analysis restricted to MSM behaviorally-indicated for PrEP, relationship-factors were also significant. Our findings suggest that PrEP implementers should look beyond risk criteria to consider shared decision-making tools that support individuals to assess whether they are appropriate PrEP candidates based on their existing HIV prevention strategies, sexual health goals, and relationship dynamics.
KeywordsPre-exposure prophylaxis PrEP candidacy Risk perception HIV prevention Men who have sex with men
The study was supported by the Good Participatory Practice Program of the Aaron Diamond AIDS Research Center. Dr. Meyers is also supported by Grant # UL1TR001866 from the National Center for Advancing Translational Sciences, National Institutes of Health Clinical and Translational Science Award program. The authors would like to acknowledge all the GPP team members and collaborators: Weibin Cheng, Yuzhou Gu, and Huifang Xu (Guangzhou Center for Disease Control and Prevention, Guangzhou, China), Xiaojie Huang (Beijing You’an Hospital, China) and the following community-based organizations: Changsha Zonda-sunshine Social Work Center, QingCai Volunteer Centre, Lingnan Partners, Zhitong, Tianyuan. We thank all our participants for their responses and their time.
This study is funded by GlaxoSmithKline. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study were in accordance with the ethical standards of the Ethics Review Committee of Fudan University, Shanghai, China (IRB00002408 & FWA00002399) and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in the study.
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