20th International AIDS Conference - Melbourne, Australia


THPE188 - Poster Exhibition

Motives and barriers to use pre-exposure prophylaxis (PrEP) to prevent HIV-infection among men having sex with men (MSM): a qualitative study

J. Bil, I. Stolte, W. van der Veldt, U. Davidovich

Public Health Service of Amsterdam, Cluster Infectious Diseases, Research Department, Amsterdam, Netherlands

Background: Pre-Exposure Prophylaxis (PrEP) is a new biomedical intervention to reduce the risk of HIV-infection in HIV-negative individuals. PrEP has shown promising results in protecting men who have sex with men (MSM) who engage in high-risk sexual behavior. Although PrEP is not yet available in the Netherlands, it is important to gain insight into the motives and barriers to use PrEP on a daily basis among MSM.
Methods: Semi-structured interviews were conducted with twenty HIV-negative MSM, recruited through the ongoing Amsterdam Cohort Studies and internet. Interviews were transcribed and analyzed using the theoretical framework of the Health Belief Model.
Results: Motives for using PrEP were: self-perceived risk for HIV-infection, the possibility to gain (additional) protection against HIV-infection, the possibility of increasing the quality of their sex life (e.g. sex without condoms), to have a broader partner choice (e.g. relationship with HIV-positive person) or wanting to take pills out of solidarity with an HIV-positive partner. Other motives to use PrEP were that PrEP was perceived a better prevention method than condoms because men perceived using medication on a daily basis is easier than using condoms during sex.
Barriers for using PrEP were: financial costs of PrEP, possible side-effects of PrEP, insufficient efficacy of PrEP, anticipated threshold of receiving PrEP (e.g. extra blood tests, counseling), adhering with daily regimen of taking PrEP and low self-perceived risk for HIV-infection. Other barriers for using PrEP were the perception that condoms were a better HIV-prevention method than PrEP because of the lower financial costs, higher efficacy of condoms, and the additional advantage of protection against other STIs than HIV.
Conclusions: The intention to use PrEP among HIV-negative MSM depends on the self-perceived susceptibility of HIV and the use of and contentment with current prevention strategies. Furthermore, the intention to use PrEP depends on the conditions for receiving PrEP, such as costs for PrEP. Advantages of using PrEP are the decreased risk of HIV infection, improvement of sex life and the possibility to engage in a relationship with an HIV-positive person. These results should be taken into account when discussions about the implementation of PrEP start in the Netherlands.

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