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Congruence between Hypothetical Willingness to Use Pre-Exposure Prophylaxis (PrEP) and Eligibility: An Online Survey among Belgian Men Having Sex with Men

Author

Listed:
  • Johannes Bullinger

    (Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium
    Faculty of Psychology, University of Vienna, Vienna 1010, Austria)

  • Thijs Reyniers

    (Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium)

  • Bea Vuylsteke

    (Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium)

  • Marie Laga

    (Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium)

  • Christiana Nöstlinger

    (Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium)

Abstract

Men who have sex with men (MSM) are at high risk for acquiring HIV in Belgium. This study explores MSMs’ hypothetical willingness to use pre-exposure prophylaxis (PrEP), assesses it against formal PrEP eligibility criteria, and identifies factors associated with incongruence between eligibility and willingness. We used data from an online survey of n = 1444 self-reported HIV-negative MSM. Participants were recruited through social media of MSM organizations and dating apps. Univariate analysis described PrEP willingness and eligibility; bivariate analyses examined how specific co-variates (socio-demographic, knowledge-related, and attitudinal and behavioral factors) were associated with eligibility and willingness. About 44% were eligible for PrEP and about 70% were willing to use it. Those who were eligible were significantly more likely be willing to take PrEP ( p < 0.001). Two incongruent groups emerged: 16% of eligible participants were unwilling and 58% of ineligible participants were willing to use PrEP. Factors associated with this incongruence were sexual risk behavior, HIV risk perception, partner status, PrEP knowledge, and attitudinal factors. Because the two groups differ in terms of profiles, it is important to tailor HIV prevention and sexual health promotion to their needs. Among those at risk but not willing to take PrEP, misconceptions about PrEP, and adequate risk perception should be addressed.

Suggested Citation

  • Johannes Bullinger & Thijs Reyniers & Bea Vuylsteke & Marie Laga & Christiana Nöstlinger, 2019. "Congruence between Hypothetical Willingness to Use Pre-Exposure Prophylaxis (PrEP) and Eligibility: An Online Survey among Belgian Men Having Sex with Men," IJERPH, MDPI, vol. 16(22), pages 1-15, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:22:p:4411-:d:285798
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    References listed on IDEAS

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    1. Gabriela B Gomez & Annick Borquez & Kelsey K Case & Ana Wheelock & Anna Vassall & Catherine Hankins, 2013. "The Cost and Impact of Scaling Up Pre-exposure Prophylaxis for HIV Prevention: A Systematic Review of Cost-Effectiveness Modelling Studies," PLOS Medicine, Public Library of Science, vol. 10(3), pages 1-16, March.
    2. Kellie Freeborn & Carmen J. Portillo, 2018. "Does pre‐exposure prophylaxis for HIV prevention in men who have sex with men change risk behaviour? A systematic review," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(17-18), pages 3254-3265, September.
    3. Holt, M. & Murphy, D.A., 2017. "Individual versus community-level risk compensation following preexposure prophylaxis of HIV," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1568-1571.
    4. Oldenburg, C.E. & Perez-Brumer, A.G. & Biello, K.B. & Landers, S.J. & Rosenberger, J.G. & Novak, D.S. & Mayer, K.H. & Mimiaga, M.J., 2015. "Transactional sex among men who have sex with men in Latin America: Economic, sociodemographic, and psychosocial factors," American Journal of Public Health, American Public Health Association, vol. 105(5), pages 95-102.
    5. Rendina, H. Jonathon & Whitfield, Thomas H.F. & Grov, Christian & Starks, Tyrel J. & Parsons, Jeffrey T., 2017. "Distinguishing hypothetical willingness from behavioral intentions to initiate HIV pre-exposure prophylaxis (PrEP): Findings from a large cohort of gay and bisexual men in the U.S," Social Science & Medicine, Elsevier, vol. 172(C), pages 115-123.
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