ArticleBMC public health2025
Utilisation of HIV pre-exposure prophylaxis and preferences of alternative long-acting modalities among men who have sex with men in Hong kong: a cross-sectional study.
Article in BMC public health, 2025. 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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Abstract
backgroundPre-exposure prophylaxis (PrEP) has changed the paradigm of HIV prevention. A majority of men who have sex with men (MSM) were using oral tablets; meanwhile alternative long-acting modalities have been and are being developed. We aimed to assess the prevalence of PrEP use and the preferences of potential long-acting PrEP in the MSM community in Hong Kong, an Asian Pacific city where free or subsidised PrEP is not available.
methodsA cross-sectional study was conducted using an online self-administered questionnaire. Eligible participants were adult MSM without HIV infection who normally resided in Hong Kong. Historical and current PrEP use, and preferences of using long-acting injectable for PrEP were tested against sociodemographic and sexual behavioural factors using chi-squared test and multivariable logistic regression model.
resultsOf the 437 responses collected, 17% had ever used PrEP and 16% were currently using PrEP. Current PrEP users were more likely to have a higher income level (adjusted odds ratio [aOR] 2.11, p = 0.04), have engaged in chemsex (aOR 4.02, p < 0.01), have a non-regular male sex partner (aOR 2.66, p = 0.02), have a male sex partner living with HIV (aOR 3.60, p < 0.01), and be inclined to have condomless sex in the future (aOR 6.86, p < 0.01). Among ever users, MSM who discontinued PrEP had a lower sexual risk than current users, such as recent history of chemsex (OR 0.22, p < 0.01) and inclination to have condomless sex (OR 0.15, p < 0.01). Long-acting injectables were accepted by 27% MSM, who were more likely to be current PrEP users (odds ratio [OR] 2.35, p < 0.01), concerned about efficacy (OR 1.66, p = 0.03), and expecting to use PrEP for more than 2 years in the future (OR 9.69, p < 0.01).
conclusionThe higher prevalence of PrEP among MSM indicated an increased awareness over the past decade. However, its promotion could have been hindered by the absence of a publicly funded or subsidised programme. While PrEP users had a higher sexual risk, the utilisation pattern would be affected by the dynamicity of sexual activities. Long-acting injectables had a moderate acceptance rate. Current PrEP users and those anticipated long-term users could be prioritised for its promotion.
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