Barriers and facilitators of Pre-exposure Prophylaxis (PrEP) intention among Chinese Men who have sex with men

Abstract Background Despite strengthened efforts on HIV prevention and control, new HIV infections continue to increase among men who have sex with men (MSM) in China. Pre-exposure prophylaxis (PrEP), a highly effective HIV prevention tool, has recently been included in the China’s Action Plan of HIV Prevention and Control. To inform future PrEP implementation, this study is to identify barriers and facilitators of PrEP intention among MSM in China. Methods A cross-sectional survey was conducted among 300 MSM in Nanjing, Jiangsu Province in 2018. Demographic information, a 7-item high-risk behavior index, PrEP use intention, PrEP-related awareness and accessibility, and a 7-item public HIV stigma scale were included in the questionnaire. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with PrEP intention. Results Overall, just 55.7% of participants had ever heard of PrEP, while 75.3% expressed willingness to use PrEP if efficacy was assured. Beliefs that ‘PrEP can prevent HIV if taken as prescribed (aOR=4.84, p<0.001), and ‘PrEP can be scaled up in the community’(aOR=3.24, p<0.001), were positively associated with PrEP intention. Concerns of side effects were negatively associated with PrEP intention (aOR=0.32, p =0.006). Conclusions Given the relatively low awareness of PrEP-related information in China, interventions on awareness and knowledge targeting high risk individuals and community are needed to scale up of oral PrEP implementation once approved by China FDA. Keywords MSM; HIV; PrEP; Intention