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Background <p>Pre-exposure prophylaxis (PrEP) has changed the paradigm of HIV prevention. A majority of men who have sex with men (MSM) were using oral tablets; meanwhile alternative long-acting modalities have been and are being developed. We aimed to assess the prevalence of PrEP use and the preferences of potential long-acting PrEP in the MSM community in Hong Kong, an Asian Pacific city where free or subsidised PrEP is not available.</p> Methods <p>A cross-sectional study was conducted using an online self-administered questionnaire. Eligible participants were adult MSM without HIV infection who normally resided in Hong Kong. Historical and current PrEP use, and preferences of using long-acting injectable for PrEP were tested against sociodemographic and sexual behavioural factors using chi-squared test and multivariable logistic regression model.</p> Results <p>Of the 437 responses collected, 17% had ever used PrEP and 16% were currently using PrEP. Current PrEP users were more likely to have a higher income level (adjusted odds ratio [aOR] 2.11, <i>p</i> = 0.04), have engaged in chemsex (aOR 4.02, <i>p</i> &lt; 0.01), have a non-regular male sex partner (aOR 2.66, <i>p</i> = 0.02), have a male sex partner living with HIV (aOR 3.60, <i>p</i> &lt; 0.01), and be inclined to have condomless sex in the future (aOR 6.86, <i>p</i> &lt; 0.01). Among ever users, MSM who discontinued PrEP had a lower sexual risk than current users, such as recent history of chemsex (OR 0.22, <i>p</i> &lt; 0.01) and inclination to have condomless sex (OR 0.15, <i>p</i> &lt; 0.01). Long-acting injectables were accepted by 27% MSM, who were more likely to be current PrEP users (odds ratio [OR] 2.35, <i>p</i> &lt; 0.01), concerned about efficacy (OR 1.66, <i>p</i> = 0.03), and expecting to use PrEP for more than 2 years in the future (OR 9.69, <i>p</i> &lt; 0.01).</p> Conclusion <p>The higher prevalence of PrEP among MSM indicated an increased awareness over the past decade. However, its promotion could have been hindered by the absence of a publicly funded or subsidised programme. While PrEP users had a higher sexual risk, the utilisation pattern would be affected by the dynamicity of sexual activities. Long-acting injectables had a moderate acceptance rate. Current PrEP users and those anticipated long-term users could be prioritised for its promotion.</p>

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Utilisation of HIV pre-exposure prophylaxis and preferences of alternative long-acting modalities among men who have sex with men in Hong kong: a cross-sectional study

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  • 发表日期：

    2025年12月26日

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  • Tsz Ho Kwan,
  • Denise Pui Chung Chan,
  • Shui Shan Lee

摘要

Background

Pre-exposure prophylaxis (PrEP) has changed the paradigm of HIV prevention. A majority of men who have sex with men (MSM) were using oral tablets; meanwhile alternative long-acting modalities have been and are being developed. We aimed to assess the prevalence of PrEP use and the preferences of potential long-acting PrEP in the MSM community in Hong Kong, an Asian Pacific city where free or subsidised PrEP is not available.

Methods

A cross-sectional study was conducted using an online self-administered questionnaire. Eligible participants were adult MSM without HIV infection who normally resided in Hong Kong. Historical and current PrEP use, and preferences of using long-acting injectable for PrEP were tested against sociodemographic and sexual behavioural factors using chi-squared test and multivariable logistic regression model.

Results

Of the 437 responses collected, 17% had ever used PrEP and 16% were currently using PrEP. Current PrEP users were more likely to have a higher income level (adjusted odds ratio [aOR] 2.11, p = 0.04), have engaged in chemsex (aOR 4.02, p < 0.01), have a non-regular male sex partner (aOR 2.66, p = 0.02), have a male sex partner living with HIV (aOR 3.60, p < 0.01), and be inclined to have condomless sex in the future (aOR 6.86, p < 0.01). Among ever users, MSM who discontinued PrEP had a lower sexual risk than current users, such as recent history of chemsex (OR 0.22, p < 0.01) and inclination to have condomless sex (OR 0.15, p < 0.01). Long-acting injectables were accepted by 27% MSM, who were more likely to be current PrEP users (odds ratio [OR] 2.35, p < 0.01), concerned about efficacy (OR 1.66, p = 0.03), and expecting to use PrEP for more than 2 years in the future (OR 9.69, p < 0.01).

Conclusion

The higher prevalence of PrEP among MSM indicated an increased awareness over the past decade. However, its promotion could have been hindered by the absence of a publicly funded or subsidised programme. While PrEP users had a higher sexual risk, the utilisation pattern would be affected by the dynamicity of sexual activities. Long-acting injectables had a moderate acceptance rate. Current PrEP users and those anticipated long-term users could be prioritised for its promotion.