Awareness,willingness to use pre-exposure prophylaxis,and use of post-exposure prophylaxis for HIV prevention among men who have sex with men in Mexico
Restricted accessResearch articleFirst published online August, 2024
Awareness,willingness to use pre-exposure prophylaxis,and use of post-exposure prophylaxis for HIV prevention among men who have sex with men in Mexico
Little is known about awareness and willingness to use or purchase HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Mexico.
Methods
MSM in Mexico were recruited via advertisements on online social venues to participate in Encuesta de Sexo Entre Hombres, an online behavioral survey. Awareness of PrEP, willingness to take PrEP if available for free, willingness to purchase PrEP, awareness of post-exposure prophylaxis (PEP), and ever PEP use were assessed in descriptive and multivariate analyses.
Results
Overall, 54.8% (4588/8376) of participants were aware of PrEP. Of those aware, 77.6% were willing to use PrEP if free and 52.6% were willing to purchase PrEP, generally at a maximum monthly cost of $500MXP. Both awareness of and willingness to use PrEP if free or for purchase were significantly greater among MSM who were younger, and varied by demographic, recent healthcare use, and behavioral risk factors. Only 8.2% had ever used PEP, which was highly associated with healthcare utilization.
Conclusions
About half of Mexican MSM were aware of PrEP. The majority of those aware were willing to use PrEP if available for free and many were willing to purchase PrEP at low cost. Leveraging demographic, recent healthcare use, and behavioral risk characteristics associated with awareness and willingness to use PrEP could be useful in designing future PrEP programs for MSM in Mexico. Expanding healthcare settings in which PEP is available may also support identifying candidates for PrEP and scaling up PrEP implementation.
AlgarinABLaraMVChapin-BardalesJ, et al.Examining geographical differences in the HIV care continuum among men who have sex with men in Mexico. AIDS Behav2023; 27: 772–782. DOI: 10.1007/s10461-022-03809-z.
5.
Bautista-ArredondoSColcheroMARomeroM, et al.Is the HIV epidemic stable among MSM in Mexico? HIV prevalence and risk behavior results from a nationally representative survey among men who have sex with men. PLoS One2013; 8(9): e72616.
6.
Vergara-OrtegaDNLópez-GatellHBautista-ArredondoS, et al.Regional disparity of HIV incidence and prevalence among men who have sex with men. BMC Infect Dis2021; 21(1): 917. DOI: 10.1186/s12879-021-06582-x.
Guerrero-TorresLB-ASCereceroDCaro-VegaY, et al.Cost-effectiveness of three different pre-exposure prophylaxis (PrEP) regimens for HIV prevention in Mexico. In: IAS Conference on HIV Science,Brisbane, Australia, July23-26, 2023.
9.
UNAIDS and AIDSinfo. AIDSinfo global data on HIV epidemiology and response. Geneva, Switzerland: UNAIDS, https://aidsinfo.unaids.org/ (2022, accessed 18 November 2022).
VelosoVGCáceresCFHoaglandBImPrEP Study Group, et al.. Same-day initiation of oral pre-exposure prophylaxis among gay, bisexual, and other cisgender men who have sex with men and transgender women in Brazil, Mexico, and Peru (ImPrEP): a prospective, single-arm, open-label, multicentre implementation study. Lancet HIV2023; 10: e84–e96. DOI: 10.1016/s2352-3018(22)00331-9.
12.
BlairKJSeguraERGarnerA, et al.PrEP awareness, use, intention to use, and information source among geosocial networking application users in Mexico in 2018–2019. AIDS Behav2021; 25(9): 2743–2754. DOI: 10.1007/s10461-021-03184-1.
13.
AssafRDKondaKATorresTS, et al.Are men who have sex with men at higher risk for HIV in Latin America more aware of PrEP?PLoS One2021; 16(8): e0255557. DOI: 10.1371/journal.pone.0255557.
14.
TorresTSKondaKAVega-RamirezEHImPrEP Study Group, et al.. Factors associated with willingness to use pre-exposure prophylaxis in Brazil, Mexico, and Peru: web-based survey among men who have sex with men. JMIR Public Health Surveill2019; 5(2): e13771. DOI: 10.2196/13771.
15.
CardoDMCulverDHCiesielskiCA, et al.A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med1997; 337(21): 1485–1490. DOI: 10.1056/nejm199711203372101.
16.
IrvineCEganKJShubberZ, et al.Efficacy of HIV postexposure prophylaxis: systematic review and meta-analysis of nonhuman primate studies. Clin Infect Dis2015; 60(suppl_3): S165–S169. DOI: 10.1093/cid/civ069.
17.
Centers for Disease Control and Prevention. Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV—United States, 2016. Atlanta, GA: Centers for Disease Control and Prevention, https://stacks.cdc.gov/view/cdc/38856 (2016, accessed 18 January 2023).
18.
Torres-CruzCSuárez-DíazE. The stratified biomedicalization of HIV prevention in Mexico City. Global Publ Health2020; 15(4): 598–610. DOI: 10.1080/17441692.2019.1679217.
19.
Baruch-DomínguezRChapin-BardalesJSmithLR, et al.Metodología de una encuesta por internet para hombres que tienen sexo con hombres en México. Salud Publica Mex2022; 64(3): 311–319. DOI: 10.21149/13126.
20.
HootsBEFinlaysonTNerlanderLNational HIV Behavioral Surveillance Study Group, et al.. Willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men—20 US cities, 2014. Clin Infect Dis2016; 63(5): 672–677. DOI: 10.1093/cid/ciw367.
21.
BarrosAJDHirakataVN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol2003; 3: 21. DOI: 10.1186/1471-2288-3-21.
22.
ZouG. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol2004; 159(7): 702–706. DOI: 10.1093/aje/kwh090.
23.
SpiegelmanDHertzmarkE. Easy SAS calculations for risk or prevalence ratios and differences. Am J Epidemiol2005; 162(3): 199–200. DOI: 10.1093/aje/kwi188.
TorresTSNascimentoARCoelhoLE, et al.Preferences for PrEP modalities among gay, bisexual, and other men who have sex with men from Brazil, Mexico, and Peru: a cross-sectional study. Ther Adv Infect Dis2023; 10: 20499361231153548. DOI: 10.1177/20499361231153548.
