Search

Low perception of HIV risk is a challenge to PrEP implementation. We analyzed associations between perceptions of PrEP candidacy, behavioral indications for PrEP, and sexual behaviors. We recruited a sample of 580 MSM from a geosocial-networking smartphone application in Paris, France. A modified Poisson regression model was conducted to examine associations between perceived candidacy for PrEP and behavioral indications for PrEP, and relationships among engagement in group sex, transactional sex, HIV test history, and indications for PrEP. Adjusted risk ratios (aRR) and 95% confidence intervals (CIs) were calculated. For the outcome of perceived candidacy for PrEP, a multinomial logistic regression was performed, and adjusted relative risk ratios (aRRR) were calculated. Multivariate analyses were adjusted for socio-demographics. Respondents who considered themselves PrEP candidates were more likely to meet PrEP eligibility criteria compared to those who did not consider themselves candidates (aRR 1.65; 95% CI 1.34–2.03). Those who had engaged in group or transactional sex were more likely to have behavioral indications for PrEP (aRR 1.27; 95% CI 1.07–1.50, aRR 1.32; 95% CI 1.13–1.56, respectively), whereas HIV test history was not significantly associated with behavioral indications for PrEP. Respondents who had engaged in group sex or transactional sex were more likely to perceive themselves as candidates for PrEP (aRRR 2.24; 95% CI 1.21–4.16, aRRR 2.58; 95% CI 1.09–6.13, respectively), although those never tested for HIV were less likely to perceive themselves as candidates for PrEP (aRRR 0.18; 95% CI 0.03–0.91). The elucidation of candidacy perceptions and risk behaviors is key to furthering the effective implementation of PrEP engagement interventions. [ABSTRACT FROM AUTHOR]

As a prevention strategy, HIV pre-exposure prophylaxis (PrEP) may benefit men who participate in group sex, but little is known about PrEP among this group internationally and virtually nothing is known of the European context. This study used an online survey of gay men living in Paris, France to assess associations between group sex and awareness of, use and interest in PrEP in its once-daily, episodic, injectable, and microbicidal forms. Men reporting recent (within 3 months) condomless group sex were much more likely to report once-daily PrEP use than men with no group sex experience (41.5% vs 7.7%, p <.001). Uptake was similarly low among men who had group sex with condoms (8.0%) and those with less-recent experience (6.43%). Overall, willingness to use PrEP—including its non-daily forms—was high among men reporting group sex, suggesting opportunities for outreach and implementation. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) commonly use inhaled nitrites, or poppers, though their use is a risk factor HIV seroconversion. Pre-exposure prophylaxis, or PrEP, is effective for HIV prevention, but is not widely used, and little is known regarding PrEP use and acceptability among MSM who use inhaled nitrites. We surveyed 580 MSM in Paris, France in 2016 about popper use, sexual behaviors including condomless anal intercourse (CAI), serosorting, and sexual positioning, PrEP use, PrEP candidacy, and interest in alternate PrEP delivery modalities. We included 444 HIV negative participants for the current study. 46.2% reported popper use in the prior 3 months. Using multivariate adjusted logistic regression, we found that popper users were more likely than non-users to consider themselves candidates for PrEP [adjusted relative risk ratio (aRRR) = 2.73; 95% CI 1.54-4.83], but they were not more likely to be current (aRRR = 1.54; 95% CI 0.71-3.33) or past (aRRR = 1.37; 95% CI 0.44-4.28) PrEP users. Mediation analyses indicated that increased CAI and serosorting partly explained the relationship between popper use and PrEP candidacy. There was considerable interest in alternate proposed PrEP delivery modalities, particularly long-acting injectable PrEP [adjusted risk ratio (aRR) = 1.43; 95% CI 1.15-1.79]. [ABSTRACT FROM AUTHOR]

The current study sought to examine awareness of, willingness to use, and preferences for available and theoretical administration modalities for HIV pre-exposure prophylaxis (PrEP) and the association of anal sex roles with these concepts among a sample of men who have sex with men (MSM) in Paris, France. Broadcast advertisements were placed on a popular geosocial-networking smartphone application for MSM to direct users to complete a Web-based survey. MSM answered questions on their recent engagement in condomless anal intercourse and awareness of and willingness to use PrEP in the form of once daily and event-driven pill regimens, long-acting injections, and penile and rectal microbicides as well as sexual roles. Multinomial regression models were fit to assess the association between behaviorally classified anal sexual role and preferences for one of these biomedical prevention modalities. A total of 482 HIV-uninfected MSM completed the survey, 48.1% of whom engaged in some form of condomless anal intercourse in the preceding 3 months. Most respondents (85.3%) had heard of once daily PrEP, but fewer respondents had heard of other prevention strategies. Assuming equal effectiveness, long-acting injections were the most commonly preferred (21.8%). Behaviorally defined "bottom" and "versatile" MSM more frequently preferred long-acting injections (32.9% of "bottoms" and 25.3% of "versatiles"). The development of long-acting injections to deliver antiretroviral drugs and topical microbicides may offer more convenient and acceptable options for HIV prevention among MSM, as MSM in this sample were willing to use them and would prefer to use them over currently available pill regimens. [ABSTRACT FROM AUTHOR]

The use of inhaled nitrites, or poppers, among men who have sex with men (MSM) is prevalent, yet has been associated with HIV seroconversion. We surveyed 580 MSM from a geosocial networking smartphone application in Paris, France, in 2016. Of the respondents, 46.7% reported popper use within the previous 3 months. Regression models adjusted for sociodemographic characteristics found that the use of poppers was significantly (P<0.05) associated with the following during the prior 3 months: condomless anal intercourse (adjusted relative risk (aRR) 1.27, 95% confidence interval (CI) 1.07-1.50), use of alcohol and/or drugs during sex once or twice (adjusted relative risk ratio (aRRR) 2.33, 95% CI 1.44-2.03), three to five times (aRRR 5.41, 95% CI 2.98-9.84) or six or more times (aRRR 4.09, 95% CI 2.22-7.56), participation in group sex (aRRR 3.70, 95% CI 2.33-5.90) and self-reported diagnosis with any sexually transmissible infection over the previous year (aRR 1.63, 95% CI 1.18-2.27), specifically chlamydia (aRR 2.75, 95% CI 1.29-4.29) and syphilis (aRR 2.27, 95% CI 1.29-4.29). [ABSTRACT FROM AUTHOR]

• Most studies investigating the role of neighborhoods in HIV-related outcomes among men who have sex with men (MSM) exclusively focus on the residential environment. • Spatial mobility was documented with both self-reported survey data and objective GPS data, which provided uncorrelated information. • Almost two-thirds (62.9%) of participants' GPS points were recorded in NYC ZIP code tabulation areas within the highest quartile of HIV prevalence. • Compared to males, it was found that transfemale, genderqueer, and other MSM spent a much higher fraction of their non-home GPS time in high HIV prevalence areas. The purpose of this study was to examine and quantify spatial mobility among HIV-negative young men who have sex with men (YMSM) within and across high prevalence HIV neighborhoods in New York City (NYC). We completed an analysis with global positioning system (GPS) and survey data to quantify spatial mobility for participants enrolled in the P18 Neighborhood Study (analytic n = 211; 83.4%). Spatial mobility was documented with self-reported survey data and objective GPS data, which was uncorrelated. Nearly one-quarter of participants (26.1%) said that they consider the neighborhood in which they currently live to differ from the neighborhood in which they had sex most frequently. In addition, 62.9% of participants' GPS points were recorded in NYC ZIP Code Tabulation Areas within the highest quartile of HIV prevalence. Future studies of YMSM populations should be conducted to examine how environments beyond the residential neighborhood can influence sexual health, which may guide HIV prevention services. [ABSTRACT FROM AUTHOR]