PrEP eligibility, HIV risk perception, and willingness to use PrEP among high-risk men who have sex with men in India: A cross-sectional survey

ABSTRACT

HIV pre-exposure prophylaxis (PrEP) is not yet included in India’s national AIDS program, with demonstration projects for MSM in planning stages. In order to support PrEP roll-out for MSM, we assessed: (1) associations between guideline-informed PrEP eligibility, HIV risk perception, and perceived PrEP benefits and costs, with willingness to use PrEP (WTUP); and (2) correlates of non-WTUP among PrEP-eligible MSM. Data were collected from MSM (n = 197) sampled from cruising sites in Mumbai and Chennai. More than half (58.4%) reported inconsistent condom use with male partners, 88.3% >1 male partner, and 48.6% engaging in sex work (all past month). Overall, 76.6% reported they would “definitely use” PrEP. Among 92.9% deemed PrEP-eligible, 79.2% reported WTUP. In adjusted analyses, PrEP eligibility (aOR = 5.31, 95% CI 1.11, 25.45), medium (aOR = 2.41, 95% CI 1.03, 5.63) or high (aOR = 13.08, 95% CI 1.29, 132.27) perceived HIV risk, and greater perceived benefits (aOR = 1.13, 95% CI 1.03, 1.24) were associated with higher odds of WTUP. Among PrEP-eligible MSM, non-WTUP was associated with low HIV risk perception and lower perceived benefits. Facilitating accurate risk assessment and promoting awareness of PrEP benefits and eligibility criteria may increase PrEP uptake among MSM in India.

KEYWORDS:

• HIV prevention
• pre-exposure prophylaxis
• perceived risk
• MSM
• India

Acknowledgements

The authors would like to thank all study participants, who gave their time and efforts for this research, and our community partners, Thozhi in Chennai and the Humsafar Trust in Mumbai, for supporting study implementation.

Disclosure statement

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

Additional information

Funding

This study was funded, in part, by grants from the Canadian Institutes of Health Research (MOP-102512; THA-118570; Newman, PI). Venkatesan Chakrapani was supported, in part, by The Wellcome Trust/DBT India Alliance Senior Fellowship (IA/CPHS/16/1/502667).