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Willingness to use and have sex with men taking HIV pre-exposure prophylaxis (PrEP): results of online surveys of Australian gay and bisexual men, 2011–2015
  1. Martin Holt1,
  2. Toby Lea1,
  3. Heather-Marie Schmidt2,
  4. Johann Kolstee3,
  5. Jeanne Ellard4,
  6. Dean Murphy1,5,
  7. Hong-Ha Truong6,
  8. John de Wit1,7
  1. 1 Centre for Social Research in Health, UNSW Australia, Sydney, New South Wales, Australia
  2. 2 Centre for Population Health, New South Wales Ministry of Health, Sydney, New South Wales, Australia
  3. 3 ACON, Sydney, New South Wales, Australia
  4. 4 Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
  5. 5 The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
  6. 6 Center for AIDS Prevention Studies, University of California, San Francisco, California, USA
  7. 7 Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
  1. Correspondence to Dr Martin Holt, Centre for Social Research in Health, Level 2, John Goodsell Building, UNSW Australia, Sydney NSW 2052, Australia; m.holt{at}unsw.edu.au

Abstract

Objective Assess willingness to use HIV pre-exposure prophylaxis (PrEP), support for others using it and willingness to have sex with partners using PrEP among Australian gay and bisexual men (GBM).

Methods National, online cross-sectional surveys of Australian GBM were conducted in 2011, 2013 and 2015. Scales measuring support for and willingness to have sex with men using PrEP were developed in 2015 using factor analysis. Trends and associations with key measures were analysed using multivariate logistic regression.

Results During 2011–2015, 3850 surveys were completed by GBM. Willingness to use PrEP among HIV-negative and untested men did not change between 2011 (28.2%) and 2015 (31.7%, p=0.13). In 2015, willingness to use PrEP was independently associated with younger age, having an HIV-positive regular partner, recent condomless anal intercourse with casual male partners (CAIC), more than 10 male sex partners in the previous 6 months, ever having taken postexposure prophylaxis and having fewer concerns about using PrEP. In 2015, 54.5% of GBM supported other GBM taking PrEP and 39% were willing to have sex with men using PrEP. Support for and willingness to have sex with PrEP users were both associated with being HIV-positive, having a university degree and having two or more male partners in the previous 6 months. Willingness to have sex with men on PrEP was also associated with recent CAIC and using party drugs for sex, but was less likely among men who consistently used or had a positive experience using condoms.

Discussion Interest in and support for using PrEP are concentrated among men who engage in higher risk practices and who know more about living with HIV. This is consistent with the targeting of PrEP in Australia.

  • HIV
  • PREVENTION
  • GAY MEN
  • ATTITUDES
  • SEXUAL BEHAVIOUR

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Footnotes

  • Handling editor Jackie A Cassell

  • Contributors All authors contributed to the study design. MH conceptualised this article and undertook the bulk of writing and redrafting. TL undertook the statistical analysis, in consultation with MH. All other authors read and commented on drafts of the article and agreed with the final version.

  • Funding Australian Government Department of Health, New South Wales Ministry of Health.

  • Competing interests This work was supported with grants from the Bloodborne virus and sexually transmissible infection Research, Intervention and Strategic Evaluation programme, funded by the New South Wales Ministry of Health, and the Australian Government Department of Health. Non-financial support from Gilead Sciences was received for studies outside the submitted work.

  • Ethics approval UNSW Australia Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement A deidentified form of the data used in this article is available on request. Requests for data can be made to the first author.

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