PrEP Willingness and Adherence Self-Efficacy Among Men Who have Sex with Men with Recent Condomless Anal Sex in Urban China

AIDS Behav. 2021 Nov;25(11):3482-3493. doi: 10.1007/s10461-021-03274-0. Epub 2021 May 1.

Abstract

This study investigates PrEP willingness, adherence self-efficacy and potential impact of PrEP among HIV-negative, Chinese men who have sex with men (MSM; n = 622) with recent condomless anal sex. Facilitative factors of PrEP willingness included migrant status, sexual risk, and prior PrEP use, whereas barriers included concerns over being treated as an HIV/AIDS patient, recent HIV testing, identity concealment, and HIV prevention service usage. Adherence self-efficacy was associated with PrEP knowledge and confidence in PrEP efficacy of HIV prevention. A total of 39.3% anticipated increase in sex partners, 25.6% anticipated decrease in condom use, and 38.0% anticipated increased HIV testing following PrEP uptake. Results suggest a two-step approach to (1) promote PrEP acceptance among Chinese MSM and (2) enhance adherence and risk monitoring among PrEP-willing MSM. Efforts to reduce stigma, incorporate PrEP in the HIV prevention continuum, and increase PrEP knowledge will be crucial to optimize PrEP implementation.

Keywords: China; Men who have sex with men; PrEP; PrEP willingness; Stigma.

MeSH terms

  • China
  • HIV Infections* / prevention & control
  • Homosexuality, Male
  • Humans
  • Male
  • Pre-Exposure Prophylaxis*
  • Self Efficacy
  • Sexual Behavior
  • Sexual Partners
  • Sexual and Gender Minorities*