Abstract
Background: Human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) has helped reduce new HIV infections. However, bacterial
sexually transmitted infections (STIs) have increased among PrEP users.
We examined PrEP knowledge, access, and risk perceptions in an age of antimicrobial resistance (AMR).
Methods: An online anonymous survey was distributed to all cisgender
men/transpersons who have sex with men attending a sexual health clinic
in Bristol, United Kingdom (October 2018 to November 2019). Interviews
with a sample identified at increased risk of HIV were analyzed thematically and integrated with survey data.
Results: Five hundred and seventy-eight (95%) of 617 cisgender men/
transpersons who have sex with men survey respondents were HIVnegative/unknown, of these, 202 (34.9%) had ever used PrEP. Interviewees(n = 24) reported widespread awareness of and enthusiasm for PrEP. Among nonusers, 39% (146/376) were unaware how to access PrEP, and 27% (103/376) could not access PrEP through the national “impact” trial
of whom 79% (81/103) were eligible. The PrEP was described as “lifechanging,” but expense was the main barrier to use. Sixty-two percent
(358/578) of HIV-negative/unknown respondents on PrEP were more likely to have condomless anal intercourse with someone they thought was HIVnegative. Interviewees used PrEP with other risk-reduction strategies.
Sexually transmitted infections were seen as “curable” and AMR rarely
influenced risk perception or sexual decision making.
sexually transmitted infections (STIs) have increased among PrEP users.
We examined PrEP knowledge, access, and risk perceptions in an age of antimicrobial resistance (AMR).
Methods: An online anonymous survey was distributed to all cisgender
men/transpersons who have sex with men attending a sexual health clinic
in Bristol, United Kingdom (October 2018 to November 2019). Interviews
with a sample identified at increased risk of HIV were analyzed thematically and integrated with survey data.
Results: Five hundred and seventy-eight (95%) of 617 cisgender men/
transpersons who have sex with men survey respondents were HIVnegative/unknown, of these, 202 (34.9%) had ever used PrEP. Interviewees(n = 24) reported widespread awareness of and enthusiasm for PrEP. Among nonusers, 39% (146/376) were unaware how to access PrEP, and 27% (103/376) could not access PrEP through the national “impact” trial
of whom 79% (81/103) were eligible. The PrEP was described as “lifechanging,” but expense was the main barrier to use. Sixty-two percent
(358/578) of HIV-negative/unknown respondents on PrEP were more likely to have condomless anal intercourse with someone they thought was HIVnegative. Interviewees used PrEP with other risk-reduction strategies.
Sexually transmitted infections were seen as “curable” and AMR rarely
influenced risk perception or sexual decision making.
| Original language | English |
|---|---|
| Pages (from-to) | 685-692 |
| Number of pages | 8 |
| Journal | Sexually Transmitted Diseases |
| Volume | 48 |
| Issue number | 9 |
| Early online date | 1 Feb 2021 |
| DOIs | |
| Publication status | Published - 1 Sept 2021 |
Bibliographical note
Funding Information:Conflict of Interest: The CHOP was developed by J.N. as part of the “Voice Programme” a European educational programme for early career researchers sponsored by Gilead Sciences Europe. K.T. receives research grant from GlaxoSmithkline for impact of gonorrhoea vaccine.
Publisher Copyright:
© Lippincott Williams & Wilkins.
Keywords
- Sexual Health
- HIV
- Sexual and Gender Minorities
- Pre-Exposure Prophylaxis
- Drug Resistance
- Microbial
- Sexually transmitted infections
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