Factors Associated with Not Seeking Post-exposure Prophylaxis for HIV Among PrEP-Naive Men Who Have Sex with Men: An...

Area of Science:

• Public Health
• Epidemiology
• HIV Prevention

Background:

• HIV post-exposure prophylaxis (PEP) uptake remains low among men who have sex with men (MSM).
• Awareness of PEP does not guarantee uptake, even among those recognizing a potential need.
• Understanding barriers to PEP seeking is critical for effective HIV prevention.

Purpose of the Study:

• To identify factors associated with not seeking PEP among MSM who were aware of it and had a potential need.
• To analyze individual and structural barriers influencing PEP utilization in a specific cohort.

Main Methods:

• Analysis of data from the ANRS-PREVENIR cohort.
• Inclusion of participants who were PrEP-naive, aware of PEP, and reported potential need in the past 12 months.
• Multivariable logistic regression to identify factors associated with PEP non-uptake.

Main Results:

• Out of 3,193 participants, 632 met the criteria, and 424 (67.1%) did not seek PEP.
• Primary reasons for non-uptake included low perceived HIV risk, fear of stigma, and reluctance towards hospital-based care.
• Factors associated with higher odds of not seeking PEP: living alone, perceived sexual risk, partner's HIV status awareness, high alcohol consumption, and 'hardcore sexual' practices.
• Factors associated with lower odds of not seeking PEP: frequent HIV testing and prior mental health consultation.

Conclusions:

• Significant individual and structural barriers hinder PEP uptake among MSM.
• Interventions should address perceived risk, stigma, healthcare access, and lifestyle factors.
• Targeted strategies are needed to improve PEP utilization and reduce HIV transmission in MSM populations.