Willingness of community-recruited men who have sex with men in Washington, DC to use long-acting injectable HIV pre-exposure prophylaxis

Abstract

Objectives: Clinical trials are currently investigating the safety and efficacy of long-acting injectable (LAI) agents as HIV pre-exposure prophylaxis (PrEP). Using National HIV Behavioral Surveillance data, we assessed the self-reported willingness of men who have sex with men (MSM) to use LAI PrEP and their preference for LAI versus daily oral PrEP. Methods: In 2014, venue-based sampling was used to recruit MSM aged 18 years in Washington, DC. Participants completed an interviewer-administered survey followed by voluntary HIV testing. This analysis included MSM who self-reported negative/unknown HIV status at study entry. Correlates of being “very likely” to use LAI PrEP and preferring it to daily oral PrEP were identified using multivariable logistic regression. Results: Of 314 participants who self-reported negative/unknown HIV status, 50% were <30 years old, 41% were non-Hispanic Black, 37% were non-Hispanic White, and 14% were Hispanic. If LAI PrEP were offered for free or covered by health insurance, 62% were very likely, 25% were somewhat likely, and 12% were unlikely to use it. Regarding preferred PrEP modality, 67% chose LAI PrEP, 24% chose oral PrEP, and 9% chose neither. Correlates of being very likely versus somewhat likely/unlikely to use LAI PrEP included age <30 years (aOR 1.64; 95% CI 1.00–2.68), reporting 6 (vs. 1) sex partners in the last year (aOR 2.60; 95% CI 1.22–5.53), previous oral PrEP use (aOR 3.67; 95% CI 1.20–11.24), and being newly identified as HIV-infected during study testing (aOR 4.83; 95% CI 1.03–22.67). Black (vs. White) men (aOR 0.48; 95% CI 0.24–0.96) and men with an income of