Abstract: Oral HIV Pre-Exposure Prophylaxis (PrEP) Among HIV-Negative Men Who Have Sex with Men in Switzerland: Acceptability According to Current Guidelines and Possible Future Adaptions (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Schedule:

Friday, January 13, 2017: 2:15 PM

La Galeries 2 (New Orleans Marriott)

* noted as presenting author

Sibylle Nideröst, PhD, Professor for Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland

Benedikt Hassler, MA, Research fellow, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland

Franziska Uggowitzer, MSc, Research fellow, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland

Patrick Weber, BA, Research Assistant, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland

Daniel Gredig, PhD, Professor for Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland

Background and Purpose

Given the high proportion of newly diagnosed HIV-infections among men who have sex with men in high-income countries, the WHO recommended in 2014 offering oral PrEP to men who have sex with men (MSM). Although PrEP has not been approved in Switzerland, it is discussed as an additional prevention option for MSM. However, little is known about the acceptability of PrEP among MSM in Switzerland. Furthermore, findings from recent and ongoing clinical trials could result in a change of PrEP regimens and guidelines in near future. Therefore, this study tried to determine the acceptability of PrEP among HIV-negative MSM living in Switzerland according to current regimens (daily oral Truvada®) and possible future regimens (being, for example, event-driven, 100% effective, free from negative side effects, or fully covered by health insurance).

Methods

In a cross-sectional study, we surveyed a convenience sample of 556 MSM living in Switzerland by using anonymous, standardized self-administered online and paper-and-pencil questionnaires. Participants were recruited through flyers distributed in bars and gay health clinics, advertisements in gay magazines and posts on various gay-specific web pages and Facebook. The current and future acceptability of PrEP was measured by six items about the intention to use PrEP according to current guidelines and possible adaptions (e.g. event-driven PrEP, 100% effectiveness, side-effects, coverage). Answers ranged from 1="extremely unlikely" to 7="extremely likely".. We carried out descriptive statistics and conducted Wilcoxon signed-ranks tests.

Results

Among the participants were 88% gay and 11% bisexual men. Mean age was 40.6 years (SD=11.9). Forty-four percent obtained a university degree. About 44% were singles. Forty-eight percent have had a sexual encounter with a casual partner during the past six months. The intention to use PrEP according to the current guidelines was moderate (Mdn=3, IQR=2-6). But the participants' intention to use PrEP increased with the possibility to obtain a drug with less side-effects (Mdn=6, IQR=4-7, Z=-13.05, p<.001) or with 100% effectiveness (Mdn=6, IQR=5-7, Z=-14.52, p<.001). Also the option of an event-driven regimen (Mdn=5, IQR=2-7, Z=-5.79, p<.001) or a full financial coverage by health insurance (Mdn=6, IQR=3-7, Z=-12.06, p<.001) significantly increased the acceptability of PrEP.

Conclusions and implications

Results indicated that the moderate acceptability of PrEP increased according to future adjustments of PrEP. Especially having a drug with less side-effects and a higher effectiveness is of importance. Moreover, financial coverage by health insurance will increase the acceptability. Before implementing PrEP in Switzerland, these issues should be considered.