Post-exposure prophylaxis: an underutilized biomedical HIV prevention method among gay, bisexual and other men who have sex with men in China

ABSTRACT

Despite abundant evidence on its safety, tolerability and cost-effectiveness, post-exposure prophylaxis (PEP) has not been officially approved for non-occupational use in China. This study aims to assess awareness of, willingness to use, and actual experience with PEP in gay, bisexual and other men who have sex with men (GBM) in China and to explore potential associations between demographic, behavioral, and psychosocial factors and PEP-related outcomes. We recruited a convenience sample through community venue-based strategies, peer referrals, and online advertisement in four cities of China in 2018. We used bivariable and multivariable logistic regression to test associations between potential predictors and PEP outcomes. Over 60% of men reported having heard of PEP prior to the survey, 70% would be willing to use it if exposed to HIV, and 6% reported having used PEP. Awareness of PEP was associated with higher education, more frequent HIV testing, knowing someone who seroconverted in the past two years, having sex with only men in the past six months, and lower perceived risk of HIV infection. PEP willingness was associated with more frequent HIV testing, being worried about becoming HIV infected, prior awareness and favorable attitudes towards PEP among friends. Findings suggest PEP is an underutilized diomedical HIV prevention intervention among GBM in China. Clinical guidance on non-occupational PEP use, as well as communication campaigns targeting social networks of GBM are needed to address barriers to PEP awareness and uptake.

KEYWORDS:

• Post-exposure prophylaxis
• Biomedical HIV prevention
• Men who have sex with men
• China

Acknowledgements

The authors thank all of the GPP team members and collaborators: Huifang Xu, Yuzhou Gu and Weibin Cheng (Guangzhou Center for Disease Control and Prevention, Guangdong, China), Min Wang (The First Hospital of Changsha, Hunan, China) and the following community-based organizations: Changsha Zonda-sunshine Social Work Center, QingCai Volunteer Centre, Lingnan Partners, Zhitong, Tianyuan. We thank all of our participants for their responses and their time. KM and YW conceived the study; JH, LX, RF, SM and HZ contributed to data collection; JH, YW, and KM drafted the manuscript; JH performed the statistic analyses. All authors contributed to manuscript revision.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported with funding from GlaxoSmithKline. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the article. This study was also supported by the Good Participatory Practices program of the Aaron Diamond AIDS Research Center. Dr. Meyers is also supportedin part by the National Center for Advancing Translational Sciences, National Institutes of Health, through Rockefeller University, Grant # UL1 TR001866.