Torres Thiago S, Nascimento Alessandro R, Coelho Lara E, Konda Kelika A, Vega-Ramirez E Hamid, Elorreaga Oliver A, Diaz-Sosa Dulce, Hoagland Brenda, Guanira Juan V, Pimenta Cristina, Benedetti Marcos, Caceres Carlos F, Veloso Valdilea G, Grinsztejn Beatriz
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Avenida Brasil, 4365 Manguinhos, Rio de Janeiro 21040-360, Brazil.
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, Brazil.
Ther Adv Infect Dis. 2023 Feb 18;10:20499361231153548. doi: 10.1177/20499361231153548. eCollection 2023 Jan-Dec.
Pre-exposure prophylaxis (PrEP) scale-up is urgent to reduce new HIV cases among gay, bisexual, and other men who have sex with men (MSM) in Latin America. Different PrEP modalities may increase PrEP uptake and adherence, especially among young MSM.
To assess preferences for PrEP modalities among MSM from Brazil, Mexico, and Peru.
Cross-sectional web-based study (March-May 2018) targeting MSM through advertisements on Grindr, Hornet, and Facebook. We included MSM aged ⩾ 18 years and who reported HIV-negative status.
We assessed preferences for PrEP modalities with the following question: 'Considering that all following PrEP modalities were available, which one would you prefer considering a scale from 1 to 3 (1 = most preferred): daily oral PrEP, event-driven PrEP (ED-PrEP), and long-acting injectable PrEP'. We assessed factors associated with each most preferred PrEP modality per country using multivariable logistic regression models.
A total of 19,457 MSM completed the questionnaire (Brazil: 58%; Mexico: 31%; Peru: 11%); median age was 28 years [interquartile range (IQR): 24-34]. Overall, injectable PrEP was the most preferred modality [42%; 95% confidence interval (CI): 41-43], followed by daily PrEP (35%; 95% CI: 34-35), and ED-PrEP (23%; 95% CI: 23-24). In multivariable models, preferring injectable PrEP was associated with PrEP awareness in all three countries, while PrEP eligibility only in Brazil. Preferring daily PrEP was associated with younger age and lower income in Brazil and Mexico, and lower education only in Brazil. The odds of preferring ED-PrEP were lower among MSM aware and eligible for PrEP in Brazil and Mexico.
Long-acting injectable PrEP was the preferred PrEP modality among MSM in Brazil, Mexico, and Peru, especially those aware and eligible for PrEP. Public health interventions to increase PrEP modalities literacy and availability in Latin America are urgent especially among MSM of young age, lower income, and lower education.
扩大暴露前预防（PrEP）对于减少拉丁美洲男同性恋、双性恋和其他与男性发生性关系的男性（MSM）中的新发艾滋病毒病例至关重要。不同的PrEP模式可能会提高PrEP的接受率和依从性，尤其是在年轻的男男性接触者中。
评估巴西、墨西哥和秘鲁男男性接触者对PrEP模式的偏好。
2018年3月至5月开展的一项基于网络的横断面研究，通过在Grindr、Hornet和Facebook上投放广告来针对男男性接触者。我们纳入了年龄≥18岁且报告艾滋病毒检测呈阴性的男男性接触者。
我们通过以下问题评估对PrEP模式的偏好：“考虑到以下所有PrEP模式都可用，从1到3（1 = 最偏好）进行评分，你会更喜欢哪种：每日口服PrEP、事件驱动的PrEP（ED-PrEP）和长效注射用PrEP”。我们使用多变量逻辑回归模型评估每个国家与每种最偏好的PrEP模式相关的因素。
共有19457名男男性接触者完成了问卷（巴西：58%；墨西哥：31%；秘鲁：11%）；中位年龄为28岁[四分位间距（IQR）：24 - 34]。总体而言，注射用PrEP是最受欢迎的模式[42%；95%置信区间（CI）：41 - 43]，其次是每日PrEP（35%；95% CI：34 - 35）和ED-PrEP（23%；95% CI：23 - 24）。在多变量模型中，在所有三个国家，更喜欢注射用PrEP与PrEP知晓率有关，而仅在巴西与PrEP资格有关。在巴西和墨西哥，更喜欢每日PrEP与年龄较小和收入较低有关，而仅在巴西与教育程度较低有关。在巴西和墨西哥，知晓并符合PrEP资格的男男性接触者中更喜欢ED-PrEP的几率较低。
长效注射用PrEP是巴西、墨西哥和秘鲁男男性接触者中首选的PrEP模式，尤其是那些知晓并符合PrEP资格的人。在拉丁美洲，尤其是在年龄较小、收入较低和教育程度较低的男男性接触者中，迫切需要开展公共卫生干预措施以提高对PrEP模式的了解和可及性。
