Interest of At Risk Boston Men Who Have Sex With Men in Oral and Topical Antiretroviral Chemoprophylaxis
Background: Studies are underway to determine whether orally or topically delivered antiretrovirals can decrease HIV incidence. Understanding prior knowledge, attitudes, experience and interest in these approaches may facilitate their uptake and effectiveness.
Methods: HIV-uninfected MSM who reported unprotected receptive anal intercourse with at least one HIV status unknown or infected partner in the prior year were enrolled at a Boston community health center in a study to determine the acceptability of rectally administered placebo gels and suppositories. Participants filled out a demographic and behavioral questionnaire at enrollment. Logistic regression procedures were used to examine demographic and behavioral factors associated with an increased likelihood to use different forms of antiviral chemoprophylaxis.
Results: The 95 MSM participants’ mean age was 39.1 years; 70.5% had more than a high school education; 24.0% were African-American and 8.6% Latino. During the prior 2 months the mean number of sex partners was 4.3. While 44.8% had heard of PEP, only 20% had heard of PrEP. Once informed about oral (PEP, PrEP) and rectal microbicides, 59.9% indicated that they would be likely to use PEP, 39.0% likely to use PrEP, and 50.0% likely to use a rectal gel for prevention. There were no demographic differences between the men who were most likely to use any one of the different chemopropylactic approaches and those who did not indicate a high likelihood of use. MSM who were most likely to use rectal microbicides were less likely to use cocaine (AOR=0.05; 95% C.I. 0.01, 0.63), but more likely to use erectile enhancement drugs (AOR=4.90; 95% C.I. 1.13,21.34) and were more likely to use PrEP (AOR=6.64; 95% C.I.=2.04, 21.66). In a final multivariable logistic regression model adjusting for participant’s age, race, and educational attainment, significant predictors of likelihood of PrEP use were increased likelihood to use PEP in the future (AOR=12.37; 95%CI = 3.27, 46.85) and likelihood of topical microbicide use(AOR=3.86; 95%CI = 1.28, 11.62).
Conclusions: Very few at risk HIV-uninfected Boston MSM had prior experience with antiviral chemoprophylaxis, but a substantial subgroup, which did not have distinctive demographic characteristics, indicated interest in both oral and rectal approaches once educated, suggesting potential for wide use.
-Abstract is available at link below-