Knowledge of and Interest in Using Preexposure Prophylaxis for HIV Prevention Among Men Who Have Sex With Men in Thailand

R. Craig Sineath, MPH; Catherine Finneran, MPH; Patrick Sullivan, DVM, PhD; Travis Sanchez, DVM, MPH; Dawn K. Smith, MD, MS, MPH; Frits van Griensven, PhD; Wipas Wimonsate, MS, MRP; Rob Stephenson, PhD

Disclosures

J Int Assoc Provid AIDS Care. 2013;12(4):227-231. 

In This Article

Abstract and Introduction

Abstract

Little is known about HIV preexposure prophylaxis (PrEP) acceptability among men who have sex with men (MSM) in Thailand. The authors recruited an online convenience sample of Thai MSM (n = 404) to assess the knowledge of and interest in PrEP. Less than 7% had heard of PrEP; however, 35% indicated interest in PrEP after an explanation of its possible efficacy. Regression modeling demonstrated that HIV knowledge and risk behavior, but not demographics, are significant predictors of PrEP interest. More information and education about PrEP is necessary and more research is needed to examine PrEP acceptability and to inform the message for PrEP uptake.

Introduction

In Thailand and worldwide, men who have sex with men (MSM) have been disproportionately affected by HIV/AIDS since the beginning of the epidemic.[1] Current Thai surveillance shows prevalence and incidence of HIV in these populations are still rising. In Bangkok, HIV prevalence among MSM recruited through venue-based sampling increased from 17.3% in 2003 to 30.8% in 2007, with incidence increasing from 4.1% to 7.7% in the same years.[2] Given the evidence of the growing HIV epidemic among MSM in Thailand, the Thai government has promoted the development of prevention strategies for MSM and has incorporated MSM as a priority group for HIV prevention in the National Plan for the Strategic and Integrated HIV/AIDS Prevention Alleviation (2007–2011).[3]

Many best-evidence HIV prevention strategies, including those endorsed by the Thai government,[3] focus on behavioral changes such as routine HIV testing, increasing condom use, and addressing substance abuse.[4] However, the results from the recent multicountry iPrEx (Pre-exposure Prophylaxis Inititative) efficacy trial of daily oral tenofovir (TDF)/emtricitabine (FTC) fixed-dose combination (FDC) for the prevention of HIV infection among MSM (including a site in northern Thailand) showed an overall efficacy of 44%.[5] With high adherence as measured by detection of TDF/FTC in blood samples, efficacy in prevention of HIV infection was greater than 90%.[6] Given these results, and the Thai government's recent focus on HIV prevention among MSM, it is possible that HIV preexposure prophylaxis (PrEP) could be added to Thailand's prevention tools for MSM alongside Thailand's commitment to provide access to antiretroviral drugs for Thai nationals living with HIV.[3]

In order to determine the impact of implementing PrEP among MSM in Thailand, more needs to be known about this population's willingness and interest to use these drugs for HIV prevention. Currently, no published data exist on the acceptability and interest or disinterest in use of PrEP among Thai MSM. Therefore, we examined the factors associated with PrEP knowledge and interest among an online recruited convenience sample of Thai MSM.

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