Attitudes Towards Treatment as Prevention Among PrEP-Experienced Gay and Bisexual Men in Australia

Alexander Dowell-Day; Timothy Dobbins; Curtis Chan; Doug Fraser; Martin Holt; Stefanie J Vaccher; Brent Clifton; Iryna Zablotska; Andrew Grulich; Benjamin R Bavinton

doi:10.1007/s10461-023-04019-x

Attitudes Towards Treatment as Prevention Among PrEP-Experienced Gay and Bisexual Men in Australia

AIDS Behav. 2023 Sep;27(9):2969-2978. doi: 10.1007/s10461-023-04019-x. Epub 2023 Mar 6.

Authors

Affiliations

¹ School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
² The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
³ Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.
⁴ National Association of People with HIV Australia, Newtown, NSW, Australia.
⁵ Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, Australia.
⁶ Sydney Infectious Diseases Institute, University of Sydney, Westmead, Australia.
⁷ Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, Australia.
⁸ The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia. bbavinton@kirby.unsw.edu.au.

Abstract

The introduction of HIV pre-exposure prophylaxis (PrEP) has the potential to impact the attitudes gay and bisexual men (GBM) who consequently choose to take PrEP have towards treatment as prevention (TasP), and the extent to which they are willing to have condomless anal intercourse (CLAI) with an HIV-positive sexual partner who has an undetectable viral load (UVL). Using a cross-sectional sample from an observational cohort study conducted from August 2018 to March 2020, we examined the extent to which PrEP-experienced GBM are willing to have CLAI with a partner who has a UVL. Simple and multiple logistic regression models were used to identify associated variables. Of the 1386 participants included in the analyses, 79.0% believed in the effectiveness of TasP, and 55.3% were willing to have CLAI with a partner who has a UVL. Wiling participants were less worried about getting HIV when taking PrEP and more likely to believe in TasP. Further research is needed to better understand the gap between belief in TasP and willingness to have CLAI with a partner who has a UVL among PrEP-experienced GBM.

Keywords: Gay and bisexual men; HIV; Men who have sex with men; Pre-exposure prophylaxis; Treatment as prevention.

Publication types

Observational Study

MeSH terms

Australia / epidemiology
Bisexuality
Cross-Sectional Studies
HIV Infections* / prevention & control
Homosexuality, Male
Humans
Male
Patient Acceptance of Health Care
Pre-Exposure Prophylaxis*
Sexual Behavior
Sexual and Gender Minorities*