Willingness to Use HIV Pre-Exposure Prophylaxis and the Likelihood of Decreased Condom Use Are Both Associated With Unprotected Anal Intercourse and the Perceived Likelihood of Becoming HIV Positive Among Australian Gay and Bisexual Men

The research team conducted the current study to determine Australian gay and bisexual men's willingness to use HIV pre-exposure prophylaxis (PrEP), as well as the likelihood of decreased use of condoms.

In April-May 2011, a national online cross-sectional survey was conducted. Bivariate relationships were assessed using Χ² or Fisher's exact test. Multivariate logistic regression analysis was used to assess independent relationships with primary outcome variables.

In all, responses from 1,161 HIV-negative and untested men were analyzed. Only six reported prior use of antiretrovirals as PrEP. More than one-quarter of the men (28.2 percent; n=327) were classified as willing to use PrEP. Such willingness was independently associated with younger age, having protected or unprotected anal intercourse with casual partners, expressing fewer concerns regarding PrEP, and perceiving oneself to be at risk of HIV infection.

Among the 327 men willing to use PrEP, just 26 (8 percent) said they would be less likely to use condoms if they were taking the preventive medication. Being less likely to use condoms with PrEP was shown to be independently associated with older age, having unprotected anal intercourse with casual partners (UAIC) and the perception that one was at increased risk of HIV infection.

"The Australian gay and bisexual men the authors surveyed were cautiously optimistic about PrEP," according to the study's conclusion. "The minority of men who expressed willingness to use PrEP appear to be appropriate candidates, given that they are likely to report UAIC and to perceive themselves to be at risk of HIV."

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