Evidence map›Paper›PMID 40810881›Full record

ArticleAIDS and behavior2026

Profiling the HIV Pre-exposure Prophylaxis (PrEP) Cascade in Japan: A Latent Class Analysis of a Nationwide Cross-Sectional Study.

Takeshi Miwa, Carol Strong, Stephane Wen-Wei Ku, Chia-Wen Li, Poyao Huang, Huei-Jiuan Wu, Masazumi Yamaguchi, Yuzuru Ikushima

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Article in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Takeshi MiwaDepartment of Public Health, College of Medicine, National Cheng Kung University, 8F-8068, No. 138, ShengLi Rd., North Dist., Tainan, 704, Taiwan.
Carol StrongDepartment of Public Health, College of Medicine, National Cheng Kung University, 8F-8068, No. 138, ShengLi Rd., North Dist., Tainan, 704, Taiwan. carol.chiajung@gmail.com.ORCID http://orcid.org/0000-0002-2934-5382
Stephane Wen-Wei KuDivision of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan.
Chia-Wen LiDivision of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Poyao HuangCollege of Public Health, Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan.
Huei-Jiuan WuThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Masazumi YamaguchiHakujikai Longevity and Rehabilitation Center Hospital, Tokyo, Japan.
Yuzuru IkushimaPositive Living And Community Empowerment TOKYO (PLACE TOKYO), Tokyo, Japan.

Funding

Ministry of Health, Labour and Welfare 20HB1007
6 · The paper itself

Abstract

To understand opportunities for improving pre-exposure prophylaxis (PrEP) uptake, this study constructed a PrEP cascade and examined subgroup profiles associated with transitions along the cascade among gay, bisexual, and other men who have sex with men (gbMSM) in Japan. An online cross-sectional survey was conducted from February to March 2021. The four-step PrEP cascade included awareness, willingness, initiation, and regimen use. Latent class analysis (LCA) identified participant subgroups, and logistic regression examined associations with the most significant drop-off in the cascade. Among 5,831 cisgender gbMSM not living with HIV (median age: 38 years), 52.6% were aware of PrEP, 76.4% of whom were willing to use it. However, only 20.5% of those willing had initiated PrEP-the largest decline in the cascade. Among those who initiated, 43.8% were on a daily regimen. LCA identified four subgroups: (i) Sexual Adventurers (32.1%)-high sexual activity and strong HIV community ties; (ii) Reserved Bystanders (26.7%)-low engagement with the HIV community and sexual health services; (iii) Positive Allies (24.6%)-strong HIV community ties and comfort discussing sexual health; and (iv) Young Explorers (16.7%)-younger, moderately sexually active, with limited HIV community ties. Compared to Reserved Bystanders, Sexual Adventurers (OR 5.27, 95% CI 3.91-7.10) and Positive Allies (OR 1.60, 95% CI 1.14-2.26) had significantly higher odds of PrEP initiation. Despite increasing acceptability, barriers to PrEP uptake persist. Targeted interventions are needed to address subgroup-specific challenges-particularly for younger gbMSM and those with limited access to HIV community networks and sexual health services.

Indexed as

Anti-HIV AgentsHIV InfectionsHomosexuality, MalePatient Acceptance of Health CarePre-Exposure ProphylaxisSexual and Gender MinoritiesAdultCross-Sectional StudiesHealth Knowledge, Attitudes, PracticeHumansJapanLatent Class AnalysisMaleMiddle AgedSexual BehaviorSurveys and QuestionnairesAnti-HIV AgentsCascadeCross-sectional surveyJapanLatent class analysisMen who have sex with menPre-exposure prophylaxis

Identifiers

PMID40810881

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.