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Pre-exposure prophylaxis (PrEP) is an effective tool to prevent HIV and has recently been approved in Taiwan. However, more research regarding PrEP acceptability and effective PrEP implementation is needed in Taiwan. Little is known about the intention to use PrEP and salient psychosocial factors among men who have sex with men (MSM). The purpose of this study was to examine health beliefs linked to PrEP use intention among young MSM (YMSM) in Taiwan. Using the Health Belief Model (HBM) as a guiding framework, an anonymous online survey was used to collect data from participants who were recruited using multiple channels to ensure diversity. Multivariate logistic regression was performed to examine the health beliefs linked to high PrEP use intention. Data from 1329 HIV-negative YMSM were analyzed; 488 (36.7%) were classified as having high PrEP use intention, which was found to be associated with having high perceived susceptibility to HIV infection [adjusted odds ratio (AOR) = 2.11], high perceived benefits of PrEP use (AOR = 2.14), high self-efficacy in PrEP use (AOR = 4.19), and many cues to action concerning PrEP use (AOR = 1.49). YMSM with high perceived barriers to PrEP use (AOR = 0.64) had lower PrEP use intention. In addition, the effects of HBM constructs and specific health beliefs on PrEP use intention varied by preferred penile–anal sexual role. The study findings may inform efforts aimed at improving PrEP acceptability and optimizing PrEP implementation programs tailored for YMSM of different sexual roles. [ABSTRACT FROM AUTHOR]

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Chemsex drug use (CDU) is a frequent, yet neglected issue in the era of treat-all policy. We evaluated the temporal pattern of CDU, factors associated with CDU, and drug–drug interactions (DDIs) between chemsex drugs and initial antiretroviral therapy (ART) by surveying 621 Taiwanese individuals (mean age: 29.7 years; 99.2% men; 92.9% men who have sex with men) diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from 2015 to 2020 [2015 to 2016 (period 1), 2017 to 2018 (period 2), and 2019 to 2020 (period 3)]. CDU was defined as chemsex in the past 1 year before HIV diagnosis. CDU remained prevalent across three periods (34.3–30.5%). Among CDU, methamphetamine (43.4%) was most frequently used, followed by amphetamine (40.0%) and poppers (various alkyl nitrites) (39.5%). We identified significantly increasing amphetamine use (37.0–61.5%) and decreasing ecstasy (methylenedioxy-methamphetamine) use (32.1–17.9%) in CDU across three periods. Besides, polydrug chemsex also significantly increased in CDU across three periods (23.5–43.6%), with amphetamine plus gamma–hydroxybutyrate being the most commonly used combination. CDU was associated with multiple sexual partners and a history of sexually transmitted diseases (STDs). DDIs between chemsex drugs and initial ART remained stable across three periods (10.6–7.8%), with cobicistat/elvitegravir and methamphetamine most common combination. In summary, the magnitude of CDU remained high across 2015–2020 in Taiwan, causing DDIs with initial ART agents. Strategies to reduce the frequency of high-risk sexual practices, STD transmission, and DDIs for newly diagnosed HIV-positive patients engaging in chemsex should be implemented. [ABSTRACT FROM AUTHOR]

In Taiwan, men who have sex with men (MSM) continue to be disproportionately affected by HIV, and the main route of HIV transmission is condomless anal intercourse (CAI). This study examined the associations between psychosociobehavioral characteristics and CAI intention among MSM in Taiwan who had ever engaged in anal intercourse with men, and compared the differences across three sexual roles (receptive, versatile, and insertive) using online survey data (N = 563). For all MSM, those that were in a relationship (AOR = 2.55; 95% CI: 1.61–4.03), had three or more steady partners (AOR = 2.58; 95% CI: 1.19–5.58), did not use a condom during last anal intercourse (AOR = 6.81; 95% CI: 4.36–10.63), perceived high HIV risk (AOR = 2.13; 95% CI: 1.26–3.60), and had high sexual sensation seeking (AOR = 2.80; 95% CI: 1.82–4.30) were more likely to have high CAI intention. After stratification, the significant characteristics differed depending on sexual role, except for no condom use during last anal intercourse remaining significant in all models (AOR = 5.09–20.30; 95% CI: 2.49–66.69, depending on sexual role). Tailoring the programs for MSM of different sexual roles may improve the effectiveness of future prevention efforts. [ABSTRACT FROM AUTHOR]

Gay and other men who have sex with men (MSM) account for the vast majority of new HIV infections in Taiwan, yet utilization of pre-exposure prophylaxis (PrEP) remains low. We examined correlates of PrEP awareness and acceptability among MSM in Taiwan. A cross-sectional survey was conducted with 176 MSM (mean age = 27.4 years) recruited through community-based organizations in two cities. Less than half of participants (47.2%) were aware of PrEP; however, when it was described to them, the majority (72.2%) indicated PrEP acceptability. In multivariable analyses, condomless anal sex was negatively associated with PrEP awareness, and higher levels of vicarious stigma and anticipated PrEP disclosure to sexual partners were positively associated with PrEP acceptability. Our findings indicate the need for targeted interventions to increase PrEP awareness among MSM engaged in high-risk behaviors and implementation strategies that address sociocultural factors to accelerate PrEP utilization among MSM in Taiwan. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) has proven to be effective in reducing the risk of HIV transmission in uninfected individuals who engaged in sexual activity with HIV-infected partners. Serodiscordant couples are the key targets of PrEP implementation. The study aimed to compare awareness of and willingness to use PrEP and anticipated condom use among 112 HIV-serodiscordant couples: 32 heterosexuals couples, 70 men who have sex with men (MSM) couples, and 10 people who inject drugs (PWID) couples. A cross-sectional study was conducted in an AIDS designated hospital in Taiwan. The PrEP survey for discordant couples included questions on awareness of non-occupational post-exposure prophylaxis (nPEP) and PrEP, attitudes toward PrEP, anticipated condom use if using PrEP, and sexual behaviors. Overall, 46.2% were aware of PrEP, only 33% were willing to take PrEP, and 44.6% would continue condom use if they were taking PrEP. Among the three key populations, MSM couples had the highest awareness of and willingness to use PrEP. Awareness of and willingness to use PrEP did not differ by HIV status, with moderate agreement (Cohen’s Kappa coefficient: 0.56) between HIV-serodiscordant partners. Both HIV-serodiscordant partners’ willingness to use PrEP was significantly associated with being MSM (adjusted odds ratio (AOR), 4.28 [1.28-14.30], p = 0.018), previous receipt of nPEP (AOR, 6.98 [1.23-39.65], p = 0.028), anticipated condom use (AOR, 0.14 [0.05-0.41], p < 0.001), and income ≥ NT$30,000 per month (AOR, 2.25 (0.99-5.04), p = 0.05). Policy makers need to consider the differences among key populations to scale up PrEP implementation. More efforts should be focused on improving awareness of and willingness to use PrEP among heterosexual and PWID serodiscordant couples to scale up PrEP implementation in Taiwan. [ABSTRACT FROM AUTHOR]

The number of HIV cases in Taiwan exceeded 30,000 in 2016. Per the UNAIDS 90-90-90 target, 81% of people living with HIV should receive medication. However, numerous previous studies focused on adherence rather than the initial healthcare seeking intention if diagnosed with HIV (HIV HSI). Based on the Theory of Planned Behavior (TPB), anonymous online survey data were collected from December 2016 through February 2017 from 2709 young MSM (YMSM) ages 15-39. Multivariate logistic regression found the significant factors and strengths of associations with HIV HSI varied by their HIV voluntary counseling and testing (VCT) experience. YMSM without VCT experience perceiving high support from salient others (AOR = 1.28) and high control under facilitating conditions (AOR = 2.73) had higher HIV HSI. YMSM with VCT experience perceiving high control under facilitating (AOR = 1.79) and constraining (AOR = 1.54) conditions had higher HIV HSI. Regardless of VCT experience, YMSM with positive attitudes toward positive healthcare seeking outcomes (AOR = 3.72-3.95) had highest HIV HSI, highlighting the importance of increasing positive outcome expectations in YMSM. [ABSTRACT FROM AUTHOR]