Overcoming the HIV Pre-Exposure Prophylaxis Uptake Barrier With A Health Action Process Approach and Conditional...

Area of Science:

• Public Health
• Behavioral Science
• HIV Prevention

Background:

• Pre-exposure prophylaxis (PrEP) awareness is high among Chinese men who have sex with men (MSM), but uptake is low.
• Financial barriers and the intention-behavior gap hinder PrEP use in China.
• Group-based conditional economic incentives (GCEIs) leverage peer influence to overcome cost-related disincentives.

Purpose of the Study:

• To evaluate HAPA-driven interventions, alone and with GCEI, for PrEP initiation and adherence.
• To address motivational and volitional barriers to PrEP use in high-risk MSM.
• To assess the effectiveness of combining behavioral science with economic incentives for HIV prevention.

Main Methods:

• Randomized controlled trial with 3 arms: HAPA intervention, HAPA + GCEI, and standard care.
• HAPA intervention included tailored WeChat messages and motivational interviews.
• GCEI component linked incentives to peer group initiation rates and group activities.
• Primary outcome: physician-prescribed PrEP initiation rate at 3 months; secondary outcomes: adherence, risk perception, stigma.

Main Results:

• 381 eligible participants were enrolled and randomized with balanced baseline characteristics.
• Outcome data collection is ongoing, with preliminary refinements to intervention components.
• Full results are expected before December 2026.

Conclusions:

• The study rigorously tests a novel intervention integrating the Health Action Process Approach (HAPA) with GCEI.
• This combined approach addresses individual barriers and financial disincentives within a group context.
• Findings will offer evidence on scalable strategies for bridging the PrEP uptake gap in China.