High interest for long-acting injectable PrEP among men who have sex with men at most risk for HIV in San Francisco, 2021
Christopher J. Hernandez
A B * , Caitlin M. Turner B C , Dillon Trujillo B D , Moranda Tate B , Jerry Quintana B , Glenda Baguso B , Katherine C. McNaughton B , Sean Arayasirikul B C , Willi McFarland B C and Erin C. Wilson B C
A
B
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D
Abstract
Men who have sex with men (MSM) represent a disproportionate total of incident HIV cases. Oral pre-exposure prophylaxis (PrEP) has contributed to significant declines in total HIV incidence. Barriers to PrEP include individual and structural factors that can prevent PrEP adherence and persistence. Long-acting injectable PrEP (LA-IP) can be leveraged to address high incident rates of HIV.
This study was a secondary analysis of the National HIV Behavioral Surveillance (NHBS) survey. We measured interest in LA-IP and associated factors among MSM in San Francisco from June 2021 to December 2021.
Of the 505 MSM who were recruited, 409 reported not living with HIV. Interest in LA-IP among MSM in San Francisco was high (78.0%). Interest was associated with the use of on-demand PrEP (adjusted prevalence ratio [aPR] 3.68, 95% confidence interval [CI] 1.24–10.9), having two or more sexual partners (aPR 3.65, 95% CI 1.89–7.03), and having condomless insertive anal intercourse (aPR 2.15, 95% CI 1.19–3.87). LA-IP was inversely associated with having a high school education or lower (aPR 0.23, 95% CI 0.08–0.70) and being aged 50 years or more (aPR 0.32, 95% CI 0.19–0.56). Strikingly, we found that five of the six participants who were found to have incident HIV infections in this study were interested in LA-IP. Further, they had used oral PrEP in the past 30 days with suboptimal adherence.
These findings suggest that a population with elevated risk for HIV and barriers to daily oral PrEP adherence may find LA-IP a preferable alternative to daily oral PrEP in meeting their HIV prevention needs.
Keywords: acceptability, adherence, HIV risk, incidence, long-acting injectable PrEP, MSM, on-demand PrEP, prevention.
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