High interest in long-acting injectable HIV pre-exposure prophylaxis among nationwide online sample of United States men who have sex with men, 2019


BACKGROUND: Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) is efficacious. Understanding the degree and variation in willingness to use LAI-PrEP among high-risk populations, such as men who have sex with men (MSM), will help inform equitable uptake of this intervention. We assessed willingness to use LAI-PrEP among a 2019 US nationwide online sample of MSM age 15+, the American Men's Internet Survey.
METHODS: Participants who did not report a prior HIV diagnosis were provided with a brief descripition of LAI-PrEP and were asked 'How likely would you be to use an injectable form of PrEP to reduce the risk of getting HIV?' with 5-point Likert scale from very likely to very unlikely. Interest in LAI-PrEP was examined by participant demographics, risk behaviors, and history of daily oral PrEP use using bivariate and multivariable ordinal logistic regression and was reported as odds ratios and 95% confidence intervals.
RESULTS: Among 2489 MSM, 72.9% were willing to use LAI-PrEP (44.9% very likely, 28.0% somewhat likely), while 17% were unlikely to use LAI-PrEP. Two-thirds of PrEP-naïve MSM and 89% of current daily oral PrEP users were very or somewhat likely to use LAI-PrEP (Table I). Likelihood of using LAI-PrEP was higher among black MSM (compared to white MSM), MSM who had condomless anal sex with a male partner, and current users of daily oral PrEP (compared to PrEP-naïve MSM).

CONCLUSIONS: Interest in LAI-PrEP is consistently high among US MSM, particularly among some groups potentially at higher risk of HIV infection. Though interest in LAI-PrEP varied by experiences with daily oral PrEP, interest was also high among those who were PrEP naïve, indicating the potential for this new PrEP modality to increase MSM engagement in biomedical HIV prevention. Monitoring of LAI-PrEP interest and exploring factors that could increase interest will be important to LAI-PrEP uptake.