HIV Vaccine Awareness and Acceptability Among Men Who Have Sex with Men in Taiwan

Background and purpose: The number of newly diagnosed HIV infections among men who have sex with men (MSM) has been consistently growing in Taiwan. Recently, the Centers for Disease Control in Taiwan estimated that half of people living with HIV/AIDS are MSM. New preventive interventions to reduce HIV infections among MSM are needed. HIV vaccine is a potential prophylactic preventive technology which can protect individuals who do not have HIV from contracting that virus. Compared to the abundance of research on HIV vaccine awareness and acceptability in other countries, little is known neither about the awareness and acceptability of an HIV vaccine, nor about the barriers to using emerging HIV preventive technologies among MSM in Taiwan. Understanding HIV vaccine awareness and acceptability necessitates resources to educate the MSM community and influence policy makers. The importance of this study is to increase awareness and acceptability of preventive measures and, ultimately, to curtail the epidemic among this population.

Methods: A cross-sectional survey was implemented using purposive sampling, and distributed in two LGBTQ community-based organizations in Taiwan. Informed consent was obtained prior to the survey. Participants completed questionnaires about socio-demographic characteristics, sexual behaviors, HIV stigma, traditional Chinese medicine, and two dichotomized dependant variables: HIV awareness and acceptability, which were analyzed using multivariate logistic regression.

Results: Two hundred MSM completed the questionnaire, for a response rate of 90.5%. Sixty-nine percent of participants were aware of research into the possibility of an HIV vaccine, and less than half (43.8%) would accept an HIV vaccine if it became available in the future. In the bivariate analysis, greater HIV vaccine awareness was associated with higher monthly income, level of education, higher number of male sex partners and lower vicarious HIV stigma. HIV vaccine acceptability did not show an association with socio-demographic, sexual behavior characteristics, HIV stigma, and traditional Chinese Medicine use. In the multivariable logistic regression model, having a college degree or higher (AOR = 2.081, CI = 1.065－4.067), having more than five sex partners in last three months (AOR = 4.243, CI = 1.154－15.603, p <0.05), and use of traditional Chinese Medicine (AOR = 0.264, CI = 0.072－0.972) were significantly associated with HIV vaccine awareness. The model of HIV vaccine acceptability does not show any statistical significance.

Conclusions and Implication: Our findings suggest a starting point for educational efforts to prepare for future HIV vaccines and other new biomedical preventive interventions. First, appropriate HIV vaccine education for MSM communities in Taiwan may help to foster awareness and acceptability. CBOs serving MSM may be helpful partners in conducting outreach and education for mitigating the stigma associated with HIV. Additionally, HIV vaccine educational programs may benefit from addressing concerns among those who use traditional Chinese Medicine, in order to build awareness and acceptability of HIV vaccines, and measures to prevent HIV infection more broadly. With vastly disproportionate HIV prevalence among MSM globally, social and behavioral research among MSM in diverse cultural settings may support the effectiveness of much needed new prevention options.