Awareness and use of nonoccupational post-exposure prophylaxis among men who have sex with men in Vancouver, Canada

S Y Lin; N J Lachowsky; M Hull; A Rich; Z Cui; P Sereda; J Jollimore; K Stephenson; M Thumath; Jsg Montaner; E A Roth; R S Hogg; D M Moore

doi:10.1111/hiv.12369

Awareness and use of nonoccupational post-exposure prophylaxis among men who have sex with men in Vancouver, Canada

HIV Med. 2016 Oct;17(9):662-73. doi: 10.1111/hiv.12369. Epub 2016 Aug 1.

Authors

S Y Lin¹, N J Lachowsky^{1

2}, M Hull^{1

2}, A Rich¹, Z Cui¹, P Sereda¹, J Jollimore³, K Stephenson⁴, M Thumath^{5

6}, Jsg Montaner^{1

2}, E A Roth^{7

8}, R S Hogg^{1

9}, D M Moore^{1

2

6}

Affiliations

¹ British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
² Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
³ Health Initiative for Men, Vancouver, BC, Canada.
⁴ Vancouver Coastal Health, Vancouver, BC, Canada.
⁵ Faculty of Nursing, University of British Columbia, Vancouver, BC, Canada.
⁶ British Columbia Centre for Disease Control, Vancouver, BC, Canada.
⁷ Department of Anthropology, Faculty of Social Sciences, University of Victoria, Victoria, BC, Canada.
⁸ Centre for Addictions Research BC, Victoria, BC, Canada.
⁹ Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.

Abstract

Objectives: Nonoccupational post-exposure prophylaxis (nPEP) is a strategy to reduce the risk of HIV infection in those with high-risk exposure. This study characterized nPEP awareness among gay, bisexual and other men who have sex with men (MSM) in Metro Vancouver, British Columbia, Canada after a pilot nPEP programme established in 2012.

Methods: Momentum Health Study participants were MSM aged ≥16 years recruited via respondent-driven sampling (RDS) who completed a computer-assisted self-interview. Stratifying patients by HIV status, we used multivariable logistic regression with backward selection to identify factors associated with nPEP awareness. All analyses were RDS-adjusted.

Results: A total of 51.9% (112 of 173) of HIV-positive and 48.5% (272 of 500) of HIV-negative participants had heard of nPEP. Only 3% (five of 106) of HIV-negative participants who reported recent high-risk sex used nPEP. Generally, nPEP awareness was higher for participants who engaged in sexual activities with increased HIV transmission potential. Factors associated with greater awareness among HIV-negative participants included recent alcohol use, higher communal sexual altruism, previous sexually transmitted infection diagnosis, and greater perceived condom use self-efficacy. Other factors associated with greater awareness among HIV-negative participants included white race/ethnicity, gay sexual identity, more formal education, lower personal sexual altruism, and Vancouver residence. Greater nPEP awareness among HIV-positive participants was associated with greater perceived agency to ask sexual partners' HIV status and more frequently reporting doing so, a higher number of lifetime receptive sex partners, and greater access to condoms.

Conclusions: Following implementation of an nPEP pilot programme, nPEP awareness among HIV-negative MSM was 51% and use was 3%. These data support the need to expand access to and actively promote nPEP services.

Keywords: HIV/AIDS prevention; clinical health services and promotion; gay and bisexual men; men who have sex with men; nonoccupational post-exposure prophylaxis.

MeSH terms

Adolescent
Adult
British Columbia
Disease Transmission, Infectious / prevention & control*
HIV Infections / prevention & control*
Health Knowledge, Attitudes, Practice*
Homosexuality, Male*
Humans
Longitudinal Studies
Male
Middle Aged
Post-Exposure Prophylaxis / statistics & numerical data*
Prospective Studies
Young Adult

Abstract

MeSH terms

Grants and funding