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London gay men anticipate some pros and cons of different PrEP methods – but optimal efficacy is key to acceptability
Roger Pebody, 2016-09-09 08:00:00

When presented with a range of possible HIV prevention technologies – a daily pill, pills before and after sex, injections, or a rectal gel – gay men in London have a range of views about which methods they would prefer, but the biggest determining factor was a method’s efficacy. Men felt they might be willing to experience more inconvenience or greater discomfort if a particular method offered them greater protection against HIV than another.

These findings, based on in-depth, qualitative interviews, come from a doctoral thesis by Will Nutland at the London School of Hygiene and Tropical Medicine. This is the first study to compare the acceptability of different HIV prevention technologies in gay men in the UK.

Twenty gay men living in London took part in interviews. All were HIV-negative and had had sex without a condom since their last HIV test – including seven who knew they’d had it with an HIV-positive man. Ages ranged from 21 to 45; the majority were white and university-educated.

The interviews were conducted in late 2012. At this stage there was relatively little public discussion or awareness of PrEP in London (the PROUD study results were released in February 2015). Interviewees were presented with the results of the iPrEx study of PrEP as a daily pill in men who have sex with men, the CAPRISA study of PrEP as a vaginal gel (microbicide) and an early safety study of an injectable antiretroviral.

As well as asking about the acceptability of daily pills, the researcher asked about pills taken before and after sex, an injection taken once a month, a long-acting implant, and a gel or foam that is inserted in the rectum before sex.