What do Dutch MSM think of preexposure prophylaxis to prevent HIV-infection? A cross-sectional study

OBJECTIVES: Although preexposure prophylaxis (PrEP) is not registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. We aimed to gain insight into PrEP awareness and the intention to use PrEP among MSM. DESIGN: Cross-sectional study among 448 HIV-negative participants of the Amsterdam Cohort Study who completed a questionnaire concerning behavior and PrEP between 2012 and 2013. METHODS: Characteristics, PrEP awareness, and intention to use PrEP were described and multinomial logistic regression was used to identify determinants of a medium and high intention to use PrEP. RESULTS: PrEP awareness was 54%, but only 13% reported a high intention to use PrEP. High-risk MSM were more likely to have a medium adjusted odds ratio (aOR): 1.78 (95% confidence interval [CI 1.07-2.97)] or high aOR: 3.92 (95% CI 1.68-9.15) intention to use PrEP than low-risk MSM, as were MSM with higher perceptions of self-efficacy to use PrEP high intention: aOR: 6.15 (95% CI 2.50-15.09) and higher perceptions of relief due to PrEP medium intention: aOR: 2.67 (95% CI 1.32-5.40); high intention: aOR: 14.87 (95% CI 5.98-37.01) than MSM with lower perceptions. MSM with higher perceptions of shame about using PrEP medium intention: aOR: 0.35 (95% CI 0.19-0.62); high intention: aOR: 0.22 (95% CI 0.07-0.71) or with more worries about side-effects were less likely to have a high aOR: 0.18 (95% CI 0.06-0.54) or medium aOR: 0.29 (95% CI 0.12-0.72) intention to use PrEP. CONCLUSION: The overall intention to use PrEP was relatively low, but higher among high-risk MSM. If PrEP implementation among high-risk MSM in the Netherlands becomes reality, PrEP awareness should be increased and psychosocial determinants that will influence uptake should be addressed.