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Awareness of Pre-exposure Prophylaxis for HIV, Willingness to Use It and Potential Barriers or Facilitators to Uptake Among Men Who Have Sex with Men in Spain

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An Erratum to this article was published on 04 June 2016

Abstract

There is a lack of data on pre-exposure prophylaxis (PrEP) effectiveness in Spain. We described the awareness of and willingness to use PrEP and examined potential barriers and facilitators to their use among men who have sex with men recruited either online or in voluntary HIV testing centers in Spain. Nearly a third of men (28.7 %) were aware of PrEP and 57.6 % said they would be willing to use it if available, 16.6 % saying they would be unwilling to use PrEP and 25.8 % not being sure. Men who had heard of PrEP were more forceful in their opinions on willingness to use PrEP (willing/not willing: 29.8 %/32.6 % vs. don’t know: 21.8 %). The greatest consensus regarding more acceptable PrEP attributes was in the mode of delivery and its cost. Doctors (91 %) or pharmacists (85.3 %) were the preferred providers. The results confirm the need to inform and educate on PrEP and define implementation strategies.

Resumen

Hay poca información disponible sobre eficacia de la profilaxis pre-exposición (PPrE) en España. Se describieron el conocimiento y aceptabilidad de la PPrE y examinaron barreras/facilitadores de su uso en hombres que tienen sexo con hombres (HSH) reclutados por internet y en centros de realización voluntaria de la prueba del VIH en España. Alrededor de 1/3 parte de los hombres (28,7 %) conocían la PPrE y 57,6 % declararon estar dispuestos a usarla si estuviera disponible, 16,6 % declararon no estarlo y 25,8 % dudaban. Los hombres que habían oído a hablar de la PPrE se mostraron más determinantes en su aceptabilidad (dispuestos/no dispuestos: 29,8 %/32,6 % vs. dudando: 21,8 %). El mayor consenso sobre las características más aceptables de la PPrE se encontró en la forma de dispensación y el coste. Los proveedores preferidos serían médicos (91 %) o farmacéuticos (85,3 %). Los resultados confirman la necesidad de informar y educar sobre la PPrE y definir estrategias de implementación.

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References

  1. European Centre for Disease Prevention and Control (ECDC)/WHO Regional in Europe. HIV/AIDS surveillance in Europe. ECDC 2013, Stockholm. 2013. http://ecdc.europa.eu/en/publications/Publications/hiv-aids-surveillance-report-Europe-2013.pdf. Cited 28 May 2015.

  2. Nicol MR, Adams JL, Kashuba AD. HIV PrEP trials: the road to success. Clin Investig. 2013;3(3):295–308. doi:10.4155/cli.12.155.

    Article  CAS  Google Scholar 

  3. Grant RM, Lama JR, Anderson PL, et al. Pre-exposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410. doi:10.1056/NEJMoa1108524.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Molina J-M, Capitant C, Spire B, et al. On demand PrEP preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373:2237–46. doi:10.1056/NEJMoa1506273.

    Article  CAS  PubMed  Google Scholar 

  6. McCormack S, Dunn DT, Desai M, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2015. doi:10.1016/S0140-6736(15)00056-2.

  7. Cairns G, McCormark S, Molina JM. The European preexposure prophylaxis revolution. Curr Opin HIV AIDS. 2016;11(1):74–9. doi:10.1097/COH.0000000000000223.

    Article  PubMed  Google Scholar 

  8. Molina JM, Pintado C, Gatey C, et al. Challenges and opportunities for oral pre-exposure prophylaxis in the prevention of HIV infection: where are we in Europe? BMC Med. 2013;11:186. doi:10.1186/1741-7015-11-186.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Young I, McDaid L. How acceptable are antiretrovirals for the prevention of sexually transmitted HIV? A review of research on the acceptability of oral pre-exposure prophylaxis and treatment as prevention. AIDS Behav. 2014;18:195–216. doi:10.1007/s10461-013-0560-7.

    Article  PubMed  Google Scholar 

  10. Eisenrgerich AB, Wheelock A, Gomez GB, Garnett GP, Dybul MR, Piot PK. Attitudes and acceptance of oral and parenteral HIV preexposure prophylaxis among potential user groups: a multinational study. PLoS One. 2012;7(2):e28238. doi:10.1371/journal.pone.0028238.

    Article  Google Scholar 

  11. Mimiaga MJ, Case P, Johnson CV, Safren SA, Mayer KH. Preexposure antiretroviral prophylaxis attitudes in high-risk Boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education. J Acquir Immune Defic Syndr. 2009;50(1):77–83. doi:10.1097/QAI.0b013e31818d5a27.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDS. 2013;27(4):248–54. doi:10.1089/apc.2012.0419.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gersh JK, Fiorillo SP, Burghardt L, et al. Attitudes and barriers towards pre-exposure prophylaxis (Prep) among high-risk HIV-seronegative men who have sex with men. J AIDS Clin Res. 2014;5:335. doi:10.4172/2155-6113.1000335.

    Google Scholar 

  14. Galea JT, Kinsler JJ, Salazar X, et al. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations. Int J STD AIDS. 2011;22(5):256–62. doi:10.1258/ijsa.2009.009255.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Leonardi M, Lee E, Tan DH. Awareness of, usage of and willingness to use HIV pre-exposure prophylaxis among men in downtown Toronto, Canada. Int J STD AIDS. 2011;22(12):738–41. doi:10.1258/ijsa.2011.011057.

    Article  CAS  PubMed  Google Scholar 

  16. Holt M, Murphy DA, Callander D, et al. Willingness to use HIV pre-exposure prophylaxis and the likelihood of decreased condom use are both associated with unprotected anal intercourse and the perceived likelihood of becoming HIV positive among Australian gay and bisexual men. Sex Transm Infect. 2012;88(4):258–63.

    Article  PubMed  Google Scholar 

  17. Wheelock A, Eisingerich AB, Ananworanich J, et al. Are Thai MSM willing to take PrEP for HIV prevention? An analysis of attitudes, preferences and acceptance. PLoS One. 2013;8(1):e54288. doi:10.1371/journal.pone.0054288.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Zhou F, Gao L, Li S, et al. Willingness to accept HIV pre-exposure prophylaxis among Chinese men who have sex with men. PLoS One. 2012;7(3):e32329. doi:10.1371/journal.pone.0032329.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Aghaizu A, Mercey D, Copas A, Johnson AM, Hart G, Nardone A. Who would use PrEP? Factors associated with intention to use among MSM in London: a community survey. Sex Transm Infect. 2013;89(3):207–11. doi:10.1136/sextrans-2012-050648.

    Article  PubMed  Google Scholar 

  20. Young I, Li J, McDaid L. Awareness and willingness to use HIV pre-exposure prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention. PLoS One. 2013;8(5):e64038. doi:10.1371/journal.pone.0064038.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Lorente N, Fugon L, Carrieri MP, et al. Acceptability of an “on demand” pre-exposure HIV prophylaxis trial among men who have sex with men living in France. AIDS Care. 2012;24(4):468–77. doi:10.1080/09540121.2011.626394.

    PubMed  Google Scholar 

  22. Rocha LM, Campos MJ, Brito J, et al. Acceptability of PrEP among HIV negative Portuguese men who have sex with men that attended 2014 Lisbon pride fair. J Int AIDS Soc. 2014;17(4 Suppl. 3):19734. doi:10.7448/IAS.17.4.19734.

    PubMed  Google Scholar 

  23. Bil JP, Davidovich U, van der Veldt WM, et al. What do Dutch MSM think of preexposure prophylaxis to prevent HIV-infection? A cross-sectional study. AIDS. 2015;29(8):955–64. doi:10.1097/QAD.0000000000000639.

    Article  PubMed  Google Scholar 

  24. Diez M, Bleda MJ, Varela JR, et al. Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009. Euro Surveill. 2014;19(47):20971.

    Article  CAS  PubMed  Google Scholar 

  25. Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT). SIVES 2012: Sistema integrat de vigilància epidemiològica del SIDA/VIH/ITS a Catalunya (SIVES): Informe biennal. Barcelona: Generalitat de Catalunya, Departament de Salut 2012. Technical Document CEEISCAT, 21.

  26. Rosenthal E, Piroth L, Cua E, et al. Preexposure prophylaxis (PrEP) of HIV infection in France: a nationwide cross-sectional study (PREVIC study). AIDS Care. 2014;26(2):176–85. doi:10.1080/09540121.2013.803014.

    Article  CAS  PubMed  Google Scholar 

  27. Krakower DS, Mimiaga MJ, Rosenberger JG, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an internet social networking site. PLoS One. 2012;7(3):e33119. doi:10.1371/journal.pone.0033119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Jain S, Krakower DS, Mayer KH. The transition from postexposure prophylaxis to preexposure prophylaxis: an emerging opportunity for biobehavioural HIV prevention. Clin Infect Dis. 2015;1(60 Suppl 3):S200–4. doi:10.1093/cid/civ094.

    Article  Google Scholar 

  29. Cohen SE, Liu AY, Bernstein KT, Philip S. Preparing for HIV pre-exposure prophylaxis: lessons learned from post-exposure prophylaxis. Am J Prev Med. 2013;44(1 Suppl. 2):S80–5. doi:10.1016/j.amepre.2012.09.036.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Research Sigma. The Sigma Panel insight Blast 6: prospective attitudes to hiv pre-exposure prophylaxis (PrEP). London: Sigma Research; 2011.

    Google Scholar 

  31. Barash EA, Golden M. Awareness and use of HIV pre-exposure prophylaxis among attendees of a Seattle gay pride event and sexually transmitted disease clinic. AIDS Patient Care STDS. 2010;24(11):689–91. doi:10.1089/apc.2010.0173.

    Article  PubMed  Google Scholar 

  32. Haire B. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence—a narrative review. HIV AIDS (Auckl). 2015;7:241–9. doi:10.2147/HIV.S72419.

    Google Scholar 

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Acknowledgments

The authors thank all participants in PrEP Study, those attending Stop Sida, Adhara and CIPS and those recruited online.

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Authors and Affiliations

  1. Centre for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain

    L. Ferrer, C. Folch, P. Fernandez-Davila, A. Garcia & J. Casabona

  2. Institut d’Investigacio Germans Trias i Pujol (IGTP), Badalona, Spain

    L. Ferrer, C. Folch, P. Fernandez-Davila, A. Garcia & J. Casabona

  3. CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain

    L. Ferrer, C. Folch, P. Fernandez-Davila, A. Garcia & J. Casabona

  4. Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autonoma de Barcelona (UAB), Bellaterra (Cerdanyola), Spain

    C. Folch & J. Casabona

  5. Stop Sida, Barcelona, Spain

    P. Fernandez-Davila & A. Morales

  6. Adhara, Sevilla, Spain

    J. Belda

  7. Centro Información y Prevención del VIH/ITS (CIPS), Alicante, Barcelona, Spain

    A. R. Susperregui

  8. Hospital Universitari Germans Trias i Pujol, Center for Epidemiological Studies on STI and AIDS of Catalonia (CEEISCAT), Ctra de Canyet s/n, 08916, Badalona, Spain

    L. Ferrer

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  1. L. Ferrer
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Ad hoc study group for PrEP acceptability

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Correspondence to L. Ferrer.

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The authors declare that they have no conflict of interest.

Additional information

Ad hoc study group for PrEP acceptability: Stop Sida—Juan Sebastian Meyer and peer-group for HIV testing, Adhara—Diego García and patient care team, CIPS—Elisa Fernández, Trinidad Zafra and Enrique Galán.

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Ferrer, L., Folch, C., Fernandez-Davila, P. et al. Awareness of Pre-exposure Prophylaxis for HIV, Willingness to Use It and Potential Barriers or Facilitators to Uptake Among Men Who Have Sex with Men in Spain. AIDS Behav 20, 1423–1433 (2016). https://doi.org/10.1007/s10461-016-1379-9

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