Ending the HIV epidemic in the United States relies on increasing use of pre-exposure prophylaxis (PrEP) medication to prevent HIV infection among men who have sex with men (MSM). A novel long-acting injectable (LAI) form of cabotegravir PrEP was approved for use in the U.S. in December 2021 under the brand name Apretude. Because the drug is so new and relatively few studies have examined acceptability of LAI PrEP among MSM, we aimed to describe willingness to use LAI PrEP and preference for PrEP form among MSM from 16 states in the southern U.S., plus Washington, D.C.
Combine is an online survey of cisgender men who have sex with men and transgender and gender expansive people who have sex with men aged 15-34 years who live in the southern region of the U.S. We analyzed outcomes related to acceptability of LAI PrEP (willingness to use LAI PrEP and preference for PrEP form) in a sample of 575 HIV-negative/unknown status MSM from 2021. We assessed bivariate associations between demographic characteristics of the study population and outcomes, and applied binomial logistic regression using predicted margins to estimate prevalence ratios. Analyses included rurality of residence, gender identity, age, education level, annual household income, health insurance status, engaging in condomless anal intercourse (CAI) within the last six months, current PrEP use, and feelings of stigma towards PrEP use.
Overall, 68% of all participants (n=393) were willing to use LAI PrEP that provides protection against HIV for three months. Fifty-six percent (n=320) indicated a preference for using LAI PrEP, compared to a daily oral pill or no preference. Willingness to use LAI PrEP was more common among men of Hispanic or other/multiracial ethnicity, cisgender males, and men who engaged in CAI in the last six months. Participants who preferred LAI PrEP were more likely to be Hispanic or of other/multiracial ethnicity.
LAI PrEP is an acceptable option among MSM in the southern United States. However, additional interventions or information campaigns targeted to non-Hispanic Black men, gender expansive people, and those with a high school education or less may be necessary
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