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RESEARCH ARTICLE

Factors influencing uptake of pre-exposure prophylaxis: some qualitative insights from an intervention study of men who have sex with men in China

Chunxing Liu A , Yingying Ding A , Zhen Ning B , Meiyang Gao A , Xing Liu A , Frank Y. Wong A C and Na He A D E
+ Author Affiliations
- Author Affiliations

A Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China.

B Shanghai Center for Disease Control and Prevention, Shanghai 200336, China.

C Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI 96813, USA

D Collaborative Innovation Centre of Social Risks Governance in Health, Fudan University, Shanghai 200032, China.

E Corresponding author. Email: nhe@fudan.edu.cn

Sexual Health - https://doi.org/10.1071/SH17075
Submitted: 7 April 2017  Accepted: 2 July 2017   Published online: 1 September 2017

Abstract

Background: Pre-exposure prophylaxis (PrEP) is a biomedical approach for preventing the acquisition of HIV in populations at substantial risk for HIV. However, its uptake among men who have sex with men (MSM) is low in China. The study aimed to identify factors that might influence MSM’s uptake and use of PrEP. Methods: In-depth interviews were conducted with 32 self-identified MSM from a PrEP intervention study evaluating daily oral tenofovir disoproxil fumarate (TDF) to prevent HIV infection. Of these men, 11 were presently using the ‘TDF’ group; 8 from the ‘change-over’ group (i.e. initially used PrEP but subsequently quitted); and 13 from the non-user group. Data were analysed using thematic approach. Results: Perception of low HIV risk, mistrust of the national PrEP program, and concerns of side effects were the main reasons for not wanting to use PrEP. Also, lack of main sexual partner’s support, difficulties in adhering to the daily TDF regimen, and the inconvenient schedules in securing the medicine were the major reasons for not wanting to use or quitting the use of PrEP. On the other hand, perceived high HIV risk, beliefs in efficacy of PrEP, and worries of transmitting HIV to families were the major motives for PrEP uptake. Conclusions: Findings suggest that PrEP implementation strategies should first address issues including but not limited to accurate self-assessment of HIV risk, mistrust and limited knowledge about medical trials and PrEP, and ease of accessing PrEP.

Additional keywords: tenofovir disoproxil fumarate, biomedical approach, HIV prevention.


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