Switching to Non-daily Pre-exposure Prophylaxis Among Gay and Bisexual Men in Australia: Implications for Improving Knowledge, Safety, and Uptake

Introduction Preexposure prophylaxis (PrEP) dosing options such as event-driven PrEP hold promise to increase PrEP uptake among gay, bisexual, and queer men (GBQM), but their impacts have not yet been realized and uptake by GBQM suitable for PrEP remains slow in countries where it is only considered...

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Bibliographic Details
Published in:Sexuality research & social policy 2022-12, Vol.19 (4), p.1979-1988
Main Authors: Philpot, Steven P., Murphy, Dean, Chan, Curtis, Haire, Bridget, Fraser, Doug, Grulich, Andrew E., Bavinton, Benjamin R.
Format: Article
Language:English
Subjects:
Access
Alternative approaches
Behavioral Science and Psychology
Bisexuality
Critical theory
Disease prevention
Dosage
HIV
Homosexuality
Human immunodeficiency virus
Knowledge
Men
Policy implementation
Prevention programs
Preventive medicine
Psychology
Safety
Sexual Behavior
Social Sciences
Teaching
Uptake
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Summary:Introduction Preexposure prophylaxis (PrEP) dosing options such as event-driven PrEP hold promise to increase PrEP uptake among gay, bisexual, and queer men (GBQM), but their impacts have not yet been realized and uptake by GBQM suitable for PrEP remains slow in countries where it is only considered an alternative option to daily PrEP. Methods We conducted semi-structured interviews between June 2020 and February 2021 with 40 GBQM in Australia to understand PrEP dosing behaviors, knowledge, and preferences. Results All participants commenced PrEP daily; 35% had ever switched to non-daily PrEP, mostly taking it event-driven. GBQM who preferred non-daily PrEP had infrequent or predictable sex, were concerned about cost given infrequency of sex, and/or wanted to minimize unnecessary drug exposure. Accurate knowledge of event-driven PrEP was poor. However, reflecting concepts underpinning critical pedagogy, having accurate knowledge was supported by access to consistent messaging across clinical, social, community, and public settings. Several participants who switched to event-driven PrEP had condomless sex events in which they were unable to adhere to pills due to unanticipated sex. Conclusions and Policy Implications Implementation of comprehensive and consistent education about correct dosing for event-driven PrEP across multiple settings is needed to ensure increased uptake and safe use. GBQM require messaging about non-condom based HIV prevention strategies when they cannot access daily or event-driven PrEP.
ISSN:1868-9884
1553-6610
DOI:10.1007/s13178-022-00736-5