Thinking beyond the tablet: Acceptability of different HIV-PrEP modalities among GBMSM and gender-diverse individuals having sex with men in the UK

Background HIV-PrEP is a key component of HIV combination prevention and has been routinely available through oral formulations (i.e. oral tablets) across sexual health services (SHSs) in the UK since 2020. We used data from a large, online community survey to assess the acceptability and preference of different HIV-PrEP modalities among gay, bisexual, and other men who have sex with men (GBMSM) and gender-diverse individuals living in the UK. Methods Using data collected from the ‘Reducing inequalities in Sexual Health’ (RiiSH) survey, an online community survey of 1106 GBMSM and gender-diverse individuals having sex with men (November/December 2023), we performed a secondary analysis examining HIV-PrEP modality acceptability and preference (e.g. oral, long acting injectable, gel, or patch) (%) by HIV-PrEP history (never, in lookback period of last 3–4 months since survey completion). Where ≥2 modalities were indicated, participants were asked to specify a single preferred modality. Single choice options were assumed to be the preferred HIV-PrEP modality. Results Irrespective of HIV-PrEP history, long acting injectables were highly acceptable (>70%) and the preferred modality (58% [222/386] by those never having used HIV-PrEP, 73% [75/103] in those without HIV-PrEP use in the lookback, 74% [314/424] in those with HIV-PrEP use in the lookback). Conclusions We found high acceptability of the use of injectables, with general preference over oral tablets. If injectable HIV-PrEP becomes available at SHSs in England, these modalities could have positive impacts on HIV-PrEP delivery, use, and access.