PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019

Dana Ogaz; Louise Logan; Tyrone J. Curtis; Lorraine McDonagh; Luis Guerra; Daniel Bradshaw; Poorvi Patel; Chiara Macri; Gary Murphy; O. Noel Gill; Anne M. Johnson; Anthony Nardone; Fiona Burns

doi:10.1186/s12889-022-13425-0

PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019

Dana Ogaz
, Louise Logan
, Tyrone J. Curtis
, Lorraine McDonagh
, Luis Guerra
, Daniel Bradshaw
, Poorvi Patel
, Chiara Macri
, Gary Murphy
, O. Noel Gill
, Anne M. Johnson
, Anthony Nardone
, Fiona Burns^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

20 Downloads (Pure)

Abstract

Background: Access to prevention options, including HIV pre-exposure prophylaxis (PrEP), remains a public health priority for gay, bisexual, and other men who have sex with men (MSM), especially in London. We describe PrEP use in a London community sample of MSM before the introduction of a national PrEP programme in October 2020.

Methods: From June–August 2019, MSM aged ≥ 18 recruited from London commercial venues were asked to self-complete a sexual health questionnaire and provide an oral fluid sample for anonymous HIV antibody testing. Descriptive analyses of demographic characteristics, service engagement and outcomes, as well as sexual risk and prevention behaviours were examined in the survey population and in those reporting current PrEP use. We performed sequential, multivariate analyses examining current PrEP use in MSM of self-perceived HIV-negative/unknown status with identified PrEP-need defined as the report of condomless anal sex (CAS) in the last three months, or the report of CAS (in the last year) with an HIV-positive/unknown status partner not known to be on HIV treatment, in reflection of UK PrEP guidelines.

Results: One thousand five hundred and thirty-fifth questionnaires were completed across 34 venues, where 1408 were analysed. One in five MSM of self-perceived HIV-negative/unknown status reported current PrEP use (19.7%, 242/1230). In men with PrEP-need, 68.2% (431/632) did not report current use. Current PrEP use was associated with age (aOR: 3.52, 95% CI: 1.76–7.02 in men aged 40–44 vs men aged 18–25) and education (aOR: 1.72, 95% CI: 1.01–2.92 in men with ≥ 2 years/still full-time vs no/ < 2 years of education since age 16).

Conclusion: Among MSM in London, PrEP use is high but there is indication of unmet PrEP-need in men of younger age and lower levels of post-16 education. National programme monitoring and evaluation will require continued community monitoring to guide interventions ensuring equitable PrEP access and uptake in those who could most benefit from PrEP.

Original language	English
Article number	1105
Journal	BMC Public Health
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12889-022-13425-0
Publication status	Published - 3 Jun 2022

Bibliographical note

Funding Information: The authors thank GMSHS 2019 study funders: Terrence Higgins Trust, the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections (BBSTI), and Public Health England. We also thank data entry and validation coordinators; participating London venues; survey participants, and GMSHS fieldworkers. We also acknowledge the members of the NIHR HPRU in the BBSTI Steering committee. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or Public Health England.

FB has received funding for development and presentation of educational materials from Gilead Sciences, Ltd. TJC was supported by a grant from the Medical Research Council (MR/N013867/1). DB received a research grant from Gilead Sciences, Ltd. AMJ is President of the Academy of Medical Sciences. All other authors have no competing interests to declare.

Funding was provided by the Terrence Higgins Trust, the National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, and Public Health England.

Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Publisher Copyright: © 2022, The Author(s).

Citation: Ogaz, D., Logan, L., Curtis, T.J. et al. PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019. BMC Public Health 22, 1105 (2022).

DOI: https://doi.org/10.1186/s12889-022-13425-0

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Bisexual
Gay
HIV
HIV pre-exposure prophylaxis
MSM
Men who have sex with men
PrEP

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Cite this

Ogaz, D., Logan, L., Curtis, T. J., McDonagh, L., Guerra, L., Bradshaw, D., Patel, P., Macri, C., Murphy, G., Noel Gill, O., Johnson, A. M., Nardone, A., & Burns, F. (2022). PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019. BMC Public Health, 22(1), Article 1105. https://doi.org/10.1186/s12889-022-13425-0

@article{6a8d7f8965bb45e08e38df0c7f1739a4,

title = "PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019",

abstract = "Background: Access to prevention options, including HIV pre-exposure prophylaxis (PrEP), remains a public health priority for gay, bisexual, and other men who have sex with men (MSM), especially in London. We describe PrEP use in a London community sample of MSM before the introduction of a national PrEP programme in October 2020. Methods: From June–August 2019, MSM aged ≥ 18 recruited from London commercial venues were asked to self-complete a sexual health questionnaire and provide an oral fluid sample for anonymous HIV antibody testing. Descriptive analyses of demographic characteristics, service engagement and outcomes, as well as sexual risk and prevention behaviours were examined in the survey population and in those reporting current PrEP use. We performed sequential, multivariate analyses examining current PrEP use in MSM of self-perceived HIV-negative/unknown status with identified PrEP-need defined as the report of condomless anal sex (CAS) in the last three months, or the report of CAS (in the last year) with an HIV-positive/unknown status partner not known to be on HIV treatment, in reflection of UK PrEP guidelines. Results: One thousand five hundred and thirty-fifth questionnaires were completed across 34 venues, where 1408 were analysed. One in five MSM of self-perceived HIV-negative/unknown status reported current PrEP use (19.7\%, 242/1230). In men with PrEP-need, 68.2\% (431/632) did not report current use. Current PrEP use was associated with age (aOR: 3.52, 95\% CI: 1.76–7.02 in men aged 40–44 vs men aged 18–25) and education (aOR: 1.72, 95\% CI: 1.01–2.92 in men with ≥ 2 years/still full-time vs no/ < 2 years of education since age 16). Conclusion: Among MSM in London, PrEP use is high but there is indication of unmet PrEP-need in men of younger age and lower levels of post-16 education. National programme monitoring and evaluation will require continued community monitoring to guide interventions ensuring equitable PrEP access and uptake in those who could most benefit from PrEP.",

keywords = "Bisexual, Gay, HIV, HIV pre-exposure prophylaxis, MSM, Men who have sex with men, PrEP",

author = "Dana Ogaz and Louise Logan and Curtis, \{Tyrone J.\} and Lorraine McDonagh and Luis Guerra and Daniel Bradshaw and Poorvi Patel and Chiara Macri and Gary Murphy and \{Noel Gill\}, O. and Johnson, \{Anne M.\} and Anthony Nardone and Fiona Burns",

note = "Funding Information: The authors thank GMSHS 2019 study funders: Terrence Higgins Trust, the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections (BBSTI), and Public Health England. We also thank data entry and validation coordinators; participating London venues; survey participants, and GMSHS fieldworkers. We also acknowledge the members of the NIHR HPRU in the BBSTI Steering committee. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or Public Health England. FB has received funding for development and presentation of educational materials from Gilead Sciences, Ltd. TJC was supported by a grant from the Medical Research Council (MR/N013867/1). DB received a research grant from Gilead Sciences, Ltd. AMJ is President of the Academy of Medical Sciences. All other authors have no competing interests to declare. Funding was provided by the Terrence Higgins Trust, the National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, and Public Health England. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Publisher Copyright: {\textcopyright} 2022, The Author(s). Citation: Ogaz, D., Logan, L., Curtis, T.J. et al. PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019. BMC Public Health 22, 1105 (2022). DOI: https://doi.org/10.1186/s12889-022-13425-0",

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Ogaz, D, Logan, L, Curtis, TJ, McDonagh, L, Guerra, L, Bradshaw, D, Patel, P, Macri, C, Murphy, G, Noel Gill, O, Johnson, AM, Nardone, A & Burns, F 2022, 'PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019', BMC Public Health, vol. 22, no. 1, 1105. https://doi.org/10.1186/s12889-022-13425-0

TY - JOUR

T1 - PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019

AU - Ogaz, Dana

AU - Logan, Louise

AU - Curtis, Tyrone J.

AU - McDonagh, Lorraine

AU - Guerra, Luis

AU - Bradshaw, Daniel

AU - Patel, Poorvi

AU - Macri, Chiara

AU - Murphy, Gary

AU - Noel Gill, O.

AU - Johnson, Anne M.

AU - Nardone, Anthony

AU - Burns, Fiona

N1 - Funding Information: The authors thank GMSHS 2019 study funders: Terrence Higgins Trust, the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections (BBSTI), and Public Health England. We also thank data entry and validation coordinators; participating London venues; survey participants, and GMSHS fieldworkers. We also acknowledge the members of the NIHR HPRU in the BBSTI Steering committee. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or Public Health England. FB has received funding for development and presentation of educational materials from Gilead Sciences, Ltd. TJC was supported by a grant from the Medical Research Council (MR/N013867/1). DB received a research grant from Gilead Sciences, Ltd. AMJ is President of the Academy of Medical Sciences. All other authors have no competing interests to declare. Funding was provided by the Terrence Higgins Trust, the National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, and Public Health England. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Publisher Copyright: © 2022, The Author(s). Citation: Ogaz, D., Logan, L., Curtis, T.J. et al. PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019. BMC Public Health 22, 1105 (2022). DOI: https://doi.org/10.1186/s12889-022-13425-0

PY - 2022/6/3

Y1 - 2022/6/3

N2 - Background: Access to prevention options, including HIV pre-exposure prophylaxis (PrEP), remains a public health priority for gay, bisexual, and other men who have sex with men (MSM), especially in London. We describe PrEP use in a London community sample of MSM before the introduction of a national PrEP programme in October 2020. Methods: From June–August 2019, MSM aged ≥ 18 recruited from London commercial venues were asked to self-complete a sexual health questionnaire and provide an oral fluid sample for anonymous HIV antibody testing. Descriptive analyses of demographic characteristics, service engagement and outcomes, as well as sexual risk and prevention behaviours were examined in the survey population and in those reporting current PrEP use. We performed sequential, multivariate analyses examining current PrEP use in MSM of self-perceived HIV-negative/unknown status with identified PrEP-need defined as the report of condomless anal sex (CAS) in the last three months, or the report of CAS (in the last year) with an HIV-positive/unknown status partner not known to be on HIV treatment, in reflection of UK PrEP guidelines. Results: One thousand five hundred and thirty-fifth questionnaires were completed across 34 venues, where 1408 were analysed. One in five MSM of self-perceived HIV-negative/unknown status reported current PrEP use (19.7%, 242/1230). In men with PrEP-need, 68.2% (431/632) did not report current use. Current PrEP use was associated with age (aOR: 3.52, 95% CI: 1.76–7.02 in men aged 40–44 vs men aged 18–25) and education (aOR: 1.72, 95% CI: 1.01–2.92 in men with ≥ 2 years/still full-time vs no/ < 2 years of education since age 16). Conclusion: Among MSM in London, PrEP use is high but there is indication of unmet PrEP-need in men of younger age and lower levels of post-16 education. National programme monitoring and evaluation will require continued community monitoring to guide interventions ensuring equitable PrEP access and uptake in those who could most benefit from PrEP.

AB - Background: Access to prevention options, including HIV pre-exposure prophylaxis (PrEP), remains a public health priority for gay, bisexual, and other men who have sex with men (MSM), especially in London. We describe PrEP use in a London community sample of MSM before the introduction of a national PrEP programme in October 2020. Methods: From June–August 2019, MSM aged ≥ 18 recruited from London commercial venues were asked to self-complete a sexual health questionnaire and provide an oral fluid sample for anonymous HIV antibody testing. Descriptive analyses of demographic characteristics, service engagement and outcomes, as well as sexual risk and prevention behaviours were examined in the survey population and in those reporting current PrEP use. We performed sequential, multivariate analyses examining current PrEP use in MSM of self-perceived HIV-negative/unknown status with identified PrEP-need defined as the report of condomless anal sex (CAS) in the last three months, or the report of CAS (in the last year) with an HIV-positive/unknown status partner not known to be on HIV treatment, in reflection of UK PrEP guidelines. Results: One thousand five hundred and thirty-fifth questionnaires were completed across 34 venues, where 1408 were analysed. One in five MSM of self-perceived HIV-negative/unknown status reported current PrEP use (19.7%, 242/1230). In men with PrEP-need, 68.2% (431/632) did not report current use. Current PrEP use was associated with age (aOR: 3.52, 95% CI: 1.76–7.02 in men aged 40–44 vs men aged 18–25) and education (aOR: 1.72, 95% CI: 1.01–2.92 in men with ≥ 2 years/still full-time vs no/ < 2 years of education since age 16). Conclusion: Among MSM in London, PrEP use is high but there is indication of unmet PrEP-need in men of younger age and lower levels of post-16 education. National programme monitoring and evaluation will require continued community monitoring to guide interventions ensuring equitable PrEP access and uptake in those who could most benefit from PrEP.

KW - Bisexual

KW - Gay

KW - HIV

KW - HIV pre-exposure prophylaxis

KW - MSM

KW - Men who have sex with men

KW - PrEP

UR - https://www.scopus.com/pages/publications/85131157126

U2 - 10.1186/s12889-022-13425-0

DO - 10.1186/s12889-022-13425-0

M3 - Article

C2 - 35659209

AN - SCOPUS:85131157126

SN - 1471-2458

VL - 22

JO - BMC Public Health

JF - BMC Public Health

IS - 1

M1 - 1105

ER -

PrEP use and unmet PrEP-need among men who have sex with men in London prior to the implementation of a national PrEP programme, a cross-sectional study from June to August 2019

Abstract

Bibliographical note

UN SDGs

Keywords

Access to Document

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