A significant proportion of men who have sex with men (MSM) attending New York City sex venues mistakenly qualified themselves as not being candidates for Truvada as pre-exposure prophylaxis (PrEP), according to a recent study. Publishing their findings in LGBT Health, researchers surveyed 629 MSM at three New York sex venues between June 2011 and June 2012 in order to determine how the men’s perception of their HIV risk and their potential candidacy for PrEP correlated with their actual candidacy.
To qualify a participant as PrEP eligible, the researchers used the entry qualifications for the iPrEx trial, which first proved PrEP’s efficacy in 2010. The men needed to have reported one of the following during the previous three months: anal sex with three or more men; transactional sex; anal sex without a condom with an HIV-positive partner or with a partner whose HIV status was not known; or a sexually transmitted infection diagnosis in the previous six months. The first qualification, however, differs from the recently released Centers for Disease Control and Prevention guidelines. When it comes to lowering the risk of sexual transmission of HIV among MSM, the CDC recommendations do not include the number of sexual partners as a criterion and only suggest PrEP for those men who have not used condoms for intercourse with other men outside of a monogamous relationship with an HIV-negative partner.
The investigators found that 80.3 percent (505) of the participants were candidates for PrEP. However, of the 469 men from this group who reported their perceived PrEP candidacy status, 78 percent (366) did not consider themselves at great enough risk to qualify for PrEP.
Those who reported condomless sex were more likely to correctly identify themselves as good candidates for PrEP.
The study is limited by the narrow demographics of the participants: MSM attending sex venues in New York City do not necessarily represent MSM at large. This study was also conducted before the recent flood of news reports and more widespread discussion of PrEP in the gay community, so general awareness of PrEP was likely lower than it is today.
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