Key points are not available for this paper at this time.
BACKGROUND: HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) are effective yet underutilized HIV prevention modalities. This study aims to evaluate the awareness-to-use cascade for PEP and PrEP, and to examine the transition from PEP to PrEP among men who have sex with men (MSM). We will discuss the rationale for using PrEP after PEP use. METHODS: With an observational, longitudinal study design, MSM were recruited from five cities in Guangxi, China. Participants completed questionnaires every 3 months and were tracked for 12 months. Descriptive statistics summarized the awareness, use, cascade and transition of PEP and PrEP. The effect of PEP use on PrEP use was analyzed using Generalized Estimating Equations. RESULTS: A total of 363 eligible MSM were recruited, and 350 participants completed at least one follow-up visit. Overall, at baseline, 96.7% were aware of PEP, and 15.2% used it. 76.0% were aware of PrEP, and 5.2% used it. According to baseline and follow-up surveys, of the 68 participants who used PEP, 29.4% reported initiating PrEP after a PEP course; of these, 60.0% did so after a single course. The median number of PEP uses before transitioning was 1 (interquartile range IQR: 1 to 2.5). The median time interval for transitioning from PEP to PrEP was 11 months (IQR: 4 to 18 months). After adjusting for sociodemographic and sexual behavior factors, having previously used PEP is one of the main predictors of PrEP use (adjusted odds ratio AOR 5.45, 95% CI: 1.80-16.50). CONCLUSIONS: Although awareness of PEP and PrEP among MSM in Guangxi, China was high, the proportion of participants initiating PEP and PrEP remained low. It is recommended that effective support and screening for transitioning to PrEP be provided after a successful first use of PEP to promote the broader implementation of HIV prevention measures.
Zhang et al. (Mon,) studied this question.