Dr. Christian Grov, Professor at the CUNY Graduate School of Public Health and Health Policy recently published a report that studied changes in willingness to use pre-exposure prophylaxis and in risk compensation. The work was published in LGBT Health.
[Dr. Christian Grov]
Although gay and bisexual men are increasingly familiar with pre-exposure prophylaxis, it is unclear whether they are willing to use it. It is also unclear how risk compensation (i.e., reduced condom use) has changed over time.
The research team conducted baseline and 12-month assessments with 158 highly sexually active HIV-negative gay and bisexual men in New York City. They examined change over time between participants (based on when they entered the study), as well as within each participant (over the 12 months of his involvement).
Familiarity with pre-exposure prophylaxis increased over time (both between and within participants); however, willingness to take pre-exposure prophylaxis did not change (neither between nor within participants). Few men believed taking pre-exposure prophylaxis would cause their condomless anal sex to increase, and this did not change over time. However, a majority thought pre-exposure prophylaxis would increase their temptation for condomless anal sex, and this did not change over time within participants. Sexual compulsivity symptomology was associated with higher willingness to take pre-exposure prophylaxis and perceiving that pre-exposure prophylaxis would increase one’s temptations for condomless anal sex. Furthermore, recent condomless anal sex was associated with greater willingness to take pre-exposure prophylaxis, a perception that pre-exposure prophylaxis would increase one’s likelihood to engage in condomless anal sex, and a perception that being on pre-exposure prophylaxis would increase one’s temptation for condomless anal sex.
The authors conclude that providers should use this as an opportunity to discuss pre-exposure prophylaxis with their patients. Men who engaged in condomless anal sex were interested in pre-exposure prophylaxis, and preexisting patterns of sexual behavior may be the primary determinant of condomless anal sex while on pre-exposure prophylaxis.