INTRODUCTION: Although pre-exposure prophylaxis (PrEP) has been available in Singapore since 2016, its uptake among gay, bisexual and other men-who-have-sex-with-men (GBMSM) is low. The iPARTY study was established to evaluate the acceptability and feasibility of PrEP and a PrEP teleconsultation service for young GBMSM aged 18 to 29 years. METHOD: A total of 53 young GBMSM were enrolled in the iPARTY study. They had a total of 5 in-person consultations and teleconsultations, at 12-week intervals. Laboratory tests and quarterly baseline surveys were performed to assess PrEP adherence, sexual behaviour, and incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). RESULTS: Thirty-five participants completed the entire 12-month follow-up. Most participants had positive experiences with PrEP teleconsultations. There was a statistically significant fall in participants' aggregate Patient Health Questionnaire-9 scores throughout the study. Self-reported PrEP adherence decreased over the course of the study, denoting improved mental health. Although self-reported condom use for anal intercourse and participants' risk perception of HIV decreased after PrEP adoption, there was no statisti-cally significant increase in STI incidence. CONCLUSION This pilot project has shown that PrEP services provide an opportunity for YMSM to access sexual health testing, treatment and counselling, and may even have tangible benefits on the mental health of this population. Teleconsultation is shown to be a suitable platform for the delivery of such services. Collaborative initiatives are crucial to further enhance the affordability and accessibility of PrEP in Singapore, and to improve patient adherence.
Adolescent ; Adult ; Humans ; Male ; Young Adult ; Anti-HIV Agents/administration & dosage* ; Feasibility Studies ; Health Risk Behaviors ; HIV Infections/psychology* ; Incidence ; Medication Adherence ; Mental Health/statistics & numerical data* ; Pilot Projects ; Pre-Exposure Prophylaxis/statistics & numerical data* ; Sexual and Gender Minorities/statistics & numerical data* ; Sexually Transmitted Diseases/prevention & control* ; Singapore/epidemiology* ; Telemedicine/statistics & numerical data* ; Homosexuality, Male/statistics & numerical data*

Objective: To understand the compliancy to on-demand HIV pre-exposure prophylaxis (PrEP) and related factors in men who have sex with men (MSM) accessing to PrEP service through an Internet platform. Methods: A cross-sectional study method was used to recruit survey respondents through the Heer Health platform from July 6 to August 30, 2022, and a questionnaire survey on the current status of medication use was conducted in MSM who use PrEP through the platform and take medication on demand. The MSM's information collected in the survey mainly included socio-demographic characteristics, behavioral characteristics, risk perception characteristics, PrEP awareness and the status of dose taking. Univariate and multivariate logistic regression analyses were used to evaluate factors related with compliancy to PrEP. Results: A total of 330 MSM who met the recruitment criteria were included during the survey period, with a valid response rate of 96.7% (319/330) to the questionnaire survey. The age of the 319 MSM was (32.5±7.3) years. Most of them had education level of junior college or college and above (94.7%, 302/319), most of them were unmarried (90.3%, 288/319), most of them had full-time works (95.9%, 306/319), and 40.8% of them had average monthly income ≥10 000 yuan (130/319). The proportion of the MSM with good compliancy to PrEP was 86.5% (276/319). The results of univariate and multivariate logistic analyses showed that the MSM with good awareness of PrEP had relatively better compliancy to PrEP compared with those with poor awareness of PrEP (aOR=2.43, 95%CI:1.11-5.32). Conclusions: The compliancy to on-demand PrEP was good in MSM who accessed to the services through Internet platform, but there is still a need to strengthen PrEP promotion in MSM for the further improvement of PrEP compliancy and reduction of the risk for HIV infection in this population.
Male ; Humans ; Adult ; HIV Infections ; Cross-Sectional Studies ; Homosexuality, Male ; Pre-Exposure Prophylaxis ; Sexual and Gender Minorities ; Internet

Objective: To understand the cognition and medication use of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in China and its associated factors. Method: From August 25 to September 5, 2021, 2 447 MSM were recruited in 24 cities to complete the online questionnaire through a male social interaction platform, Blued 7.5 software. The survey contents included demographic information of the respondents, PrEP awareness and usage, and risk behaviors. Descriptive analysis and multi-level logistic regression were performed for data analysis. SPSS 24.0 and SAS 9.4 software were used for statistical analysis. Results: Among the 2 447 respondents of MSM, 1 712 (69.96%) had heard of PrEP, 437 (17.86%) ever used PrEP, 274 (11.20%) were on PrEP, and 163 (6.66%) had discontinued PrEP; among the 437 cases (whoever used PrEP), more than 61.88% (388/627) adopted emtricitabine/tenofovir disoproxil fumarate regimen, and most of them adopted on-demand regimen. The average PrEP dosage reported in the past year is 1.12 tabletsper person per week. PrEP purchase was primarily via an online channel, and the most concerned factor was the PrEP effectiveness on HIV prevention. The most common reasons for discontinuing PrEP, reported by 163 cases, were the lack of HIV risk perception, the use of a condom to prevent HIV, and the economic burden of PrEP use. The logistic regression analysis showed that PrEP use among MSM in 24 cities was statistically associated with age, monthly income, ever having unprotected anal sex in the past year, used sexual drugs and sexually transmitted disease (STD) diagnosis in the past year. Compared with MSM aged 18-24, the proportion of MSM was relatively lower among those aged 25-44, who discontinued the PrEP (aOR=0.54,95%CI:0.34-0.87) or never used PrEP (aOR=0.62,95%CI:0.44-0.87). The proportion of unprotected anal sex among MSM currently on PrEP use was higher than those who have stopped PrEP and never used PrEP (all P<0.05). Those MSM group, with monthly income higher than 5 000 Yuan, used sexual drugs and STD diagnosis in the past year were more likely to have a higher rate for PrEP usage (all P<0.05). Conclusions: Currently, pre-exposure prophylaxis in the MSM group is primarily obtained via the online channel and adopted in an on-demand mode. Although the PrEP users have reached a certain proportion, it is still necessary to strengthen health education on the PrEP effects and side effects of MSM and to improve the awareness and use rate, especially for young MSM group, which can be combined with the advantages of the internet targeting its needs and use barriers.
Humans ; Male ; Homosexuality, Male ; Pre-Exposure Prophylaxis ; Cities ; Sexual and Gender Minorities ; Sexual Behavior ; China ; HIV Infections/prevention & control*

OBJECTIVE: To explore the discrepancy between behavioral-indicated candidacy and perceived candidacy (behavioral-perceived gap) and its associated factors of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), so as to identify the focus population of PrEP interventions and to design and implement targeted interventions. METHODS: We recruited a sample of 622 HIV-negative MSM who were regular clients of a community-based organization located in Chengdu, China, from November to December 2021. A cross-sectional questionnaire was used to collect the participants' information on social demographics, PrEP-related knowledge and cognitions, and risk behaviors. In this study, behaviorally eligible for PrEP was defined as performing at least one type of high-risk behavior in the past six months, including inconsistent condom use, sex with an HIV-positive partner, confirmed sexual transmitted infections (STI) diagnosis, substance use, and post-exposure prophylaxis (PEP) experience. Logistic regression models were fitted, and multivariate analyses were adjusted for social demographics. RESULTS: Among the 622 eligible participants, 52.6% (327/622) were classified as behaviorally eligible for PrEP. Only 37.9% (124/327) of the participants perceived themselves as appropriate candidates for PrEP and 62.1% (203/207) had discrepancy between behavioral-indicated and perceived candidacy. 85.9% (281/327) had heard of PrEP, and 14.2% (40/281) accessed PrEP information through health care providers. Of the 327 participants eligible for behavior-indicated PrEP use, about half (47.1%) knew how to obtain PrEP medication and 33.0% had a professional PrEP counseling experience. The majority (93.3%) had no or few friends using PrEP. 54.1% scored eight or above in PrEP knowledge level. 66.7% reported having two or more sexual partners in the past six months. After adjusting for age and recruitment channel, we found six factors that were associated with perceived candidacy for PrEP, including PEP use [adjusted odds ratio (OR_A)=2.20; 95% confidence interval (CI): 1.33-3.63], PrEP availability (OR_A=1.69; 95%CI: 1.06-2.68), a greater number of PrEP-using friends (OR_A=4.92; 95%CI: 1.77-13.65), PrEP know-ledge (OR_A=2.21; 95%CI: 1.38-3.56), multiple sexual partnership (OR_A=1.77; 95%CI: 1.07-2.94), and perceiving a higher risk of HIV infection (OR_A=4.02; 95%CI: 1.73-9.32). Substance use during sex and PrEP information channel were not statistically associated with this beha-vioral-perceived gap. CONCLUSION We observed a high discrepancy between behavioral-indicated and perceived candidacy for PrEP among Chengdu MSM in China. Future PrEP implementation efforts should be made in skills training in assessing HIV infection risk, increasing PrEP knowledge, providing professional PrEP counselling, and fostering PrEP support environment.
Male ; Humans ; Homosexuality, Male/psychology* ; HIV Infections/psychology* ; Pre-Exposure Prophylaxis ; HIV ; Cross-Sectional Studies ; Sexual and Gender Minorities

Humans ; HIV Infections/prevention & control* ; Pre-Exposure Prophylaxis

Men who have sex with men (MSM) is a group of people at high risk for HIV infection in China, Pre-exposure prophylaxis (PrEP) is a bioprophylaxis strategy in the prevention of HIV infection in MSM, which can reduce the risk for HIV infection in this population effectively. However, in the paractice, the use level of PrEP in MSM is low in China, and there are MSM who know PrEP but receive no PrEP. This paper summarizes the current status of the awareness, willingness to use, actual use of PrEP in MSM and influencing factors both at home and abroad to provide a reference for the promotion of PrEP use in MSM in China.
Male ; Humans ; Pre-Exposure Prophylaxis ; Homosexuality, Male ; HIV Infections/prevention & control* ; Health Knowledge, Attitudes, Practice ; Sexual and Gender Minorities

Objective: To investigate the willingness to use three types of pre-exposure prophylaxis (PrEP) and its associated factors among MSM in Chengdu. Methods: A total of 793 MSM were recruited through Chengdu Tongle Health Consultation Service Centre between November 2021 to January 2022. Data were collected, including demographic characteristics, sexual behaviors in the last six months, PrEP-related stigma, HIV anticipated stigma, MSM internalized stigma, and willingness to use three types of PrEP. Univariate and multivariate logistic regression models were conducted to investigate the associated factors of willingness in using the three types of PrEP. Results: Among 793 participants, willingness to take on-demand PrEP was higher (68.3%). Higher education and multiple sexual partners increased the willingness to use oral PrEP, higher education [compared with junior high school or below, high school or technical secondary school (aOR=2.43, 95%CI: 1.13-5.21), junior college (aOR=2.67, 95%CI: 1.27-5.61), bachelor degree (aOR=3.21, 95%CI: 1.52-6.74), master degree or above (aOR=3.77, 95%CI: 1.54-9.26)], multiple sexual partners (aOR=1.54, 95%CI: 1.12-2.11) were positively associated with daily oral PrEP. HIV anticipated stigma was positively associated with the willingness in using all three types of PrEP: daily oral PrEP (aOR=1.07, 95%CI: 1.02-1.12), on-demand PrEP (aOR=1.09, 95%CI: 1.03-1.15), and injectable PrEP every 8 week (aOR=1.06, 95%CI: 1.01-1.11). Conclusions: The overall willingness in using PrEP in MSM in Chengdu is relatively high, and the promotion of PrEP is highly feasible. In the future, we should continue to promote publicity and education on HIV and PrEP-related knowledge in this population, improve the cognitive level, and guide MSM to establish the correct motivation for PrEP use.
Male ; Humans ; Pre-Exposure Prophylaxis ; Homosexuality, Male ; Sexual and Gender Minorities ; Sexual Behavior ; HIV Infections/prevention & control*

Objective: To systematically evaluate the acceptance of pre-exposure prophylaxis (PrEP)among men who have sex with men (MSM) in China, so as to provide reference for the promotion of preventive drug use before human immunodeficiency virus exposure in China. Methods: By searching the databases of China national knowledge infrastructure, VIP database, Wanfan knowledge service platform, PubMed, Web of Science, Embase and The Cochrane Library with key words of "men who have sex with men" "pre-exposure prophylaxis" "PrEP" and "MSM". The literature on the willingness of Chinese MSM population to accept PrEP was systematically collected, and the data of the literature meeting the inclusion criteria were extracted for Meta analysis. Results: A total of 12 articles were selected in this study, including 6 articles in English and 6 in Chinese. The score of bias risk assessment of eligible articles was 14-18, which was more than 70% of the total score. The total number of samples was 11 269. The overall acceptance rate of PrEP was 0.77(95%CI:0.71-0.82). In subgroup analysis, the acceptance rates of different nationalities, marriage, household registration, age, education background, income, sexual orientation, sexual behavior and awareness of PrEP were statistically significant. Conclusion: In general, the acceptance rate of PrEP in MSM population is higher, but the awareness rate is low. There are differences in the acceptance rate among different groups.
China/epidemiology* ; Female ; HIV Infections/prevention & control* ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Male ; Patient Acceptance of Health Care ; Pre-Exposure Prophylaxis ; Sexual Behavior ; Sexual and Gender Minorities

Anti-HIV Agents/therapeutic use* ; China ; Consensus ; HIV ; HIV Infections/prevention & control* ; Humans ; Pre-Exposure Prophylaxis

BACKGROUND: We aimed to investigate the awareness of human immunodeficiency virus (HIV) infection among high-risk individuals, including men who have sex with men (MSM) and medical personnel (MP) in Korea through a cross-sectional survey, identify possible obstacles hindering their access to pre-exposure prophylaxis (PrEP). METHODS: In 2016, the first questionnaire survey was sent to randomly selected MSM and MP. To compare the changes in attitudes and knowledge of MSM, a second questionnaire survey was conducted in August 2017. RESULTS: More than half of MSM (61.3% in 2016, 88.6% in 2017) were aware of PrEP. However, MP who offered PrEP had less knowledge regarding PrEP (23.4%). The background knowledge and experience with PrEP among MSM and MP in this survey was low (3.4% in 2016 and 5.7% in 2017, 1.9% in MP). The major obstacles that MSM reported were lack of insurance coverage (29% in 2016 and 32% in 2017), concern regarding adverse effects of PrEP (19% and 21%), and risk of exposing HIV-positive status to other people (15% and 18%). Among MP, lack of knowledge regarding the efficacy of PrEP was the most common obstacle (30%), followed by lack of insurance coverage (22%), and concern regarding adverse effects (20%). CONCLUSION: Our study showed that PrEP is required among MSM in Korea; however, most MP were not aware of PrEP. Lack of insurance coverage and knowledge regarding PrEP were major hindrances in the access to PrEP; therefore, further studies on how to make PrEP information more accessible are needed to help prevent HIV infection.
Cross-Sectional Studies ; HIV Infections ; HIV* ; Humans ; Insurance Coverage ; Korea* ; Male ; Pre-Exposure Prophylaxis*