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Participants completed an interviewer-administered survey followed by voluntary HIV testing. Black vs. White men aOR 0. This is an open access article distributed under the terms of the Creative Commons Attributionwhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Therefore, we are unable to the raw data set for public access. However, a limited, de-identified analytical data set can be made available. Non-DC DOH investigators with approved concept proposals must data use and nondisclosure agreements in order to access a limited, de-identified analytical data set.

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The CDC had no role in study de, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. research has found that MSM expressed concerns about the necessity of taking a pill every day and about the potential for other people including sexual partners to discover their PrEP use [ 5 — 7 ]. Daily oral drug regimens can be challenging in general due to pill fatigue and the ongoing need to remember to take medication daily [ 7 ], particularly among younger populations, as PrEP adherence was found to be low in one PrEP trial of young MSM [ 9 ].

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Clinical trials are underway to investigate the safety and efficacy of long-acting injectable LAI agents as PrEP, which could overcome adherence challenges associated with daily oral PrEP and maintain adequate levels of PrEP in the blood for a longer period of time following drug administration [ 1011 ]. In that study HPTNa long-acting formulation of the integrase inhibitor cabotegravir is administered via intramuscular injection at two time points one month apart followed by every two months thereafter [ 12 ].

However, that study provided participants with three other HIV prevention options in addition to daily oral PrEP and LAI PrEP—condoms and two subcutaneous implant options—and considered participants to have preferred one of the five options if it was consistently selected over all other options in pairwise comparisons; thus, a direct comparison between preference for daily oral versus LAI PrEP was not possible, as many participants consistently preferred condoms or implants [ 17 ].

One other study was conducted among a more diverse sample of young MSM, though it comprised of men who had already been engaged in HIV prevention services as research participants in a longitudinal cohort study for several years [ 16 ]. Recruitment was completed between August and December using venue-based time-space sampling. In brief, a sampling frame of eligible venues was generated that included all potential public venues from which MSM could be recruited.

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On a monthly basis, a calendar of recruitment events was created by randomly selecting venues and corresponding days and times of Local sex free latinas washington week. At each recruitment event, men attending the venue were systematically approached for recruitment and screening for the study. Eligibility criteria included being at least 18 years old, being born male and identifying as male, reporting oral or anal sex with a male partner in the last 12 months, being able to complete the survey in English, and living in the Washington, DC Metropolitan Statistical Area.

Once study staff determined that a potential participant was eligible, individuals provided informed consent and completed an interviewer-administrated behavioral survey. Test from the HIV rapid test were returned after completion of the behavioral survey; thus, we defined being newly identified as HIV-infected during study testing i.

All individuals screening preliminary positive were pre-emptively referred to HIV care. All study participants provided informed verbal consent for the behavioral survey and the HIV test, which was documented on paper by the interviewers on a copy of the consent form that was retained by study staff and electronically in the study tablet.

Verbal instead of written consent was obtained due to the sensitive nature of questions and also to maintain participant anonymity. For analytic purposes, we dichotomized the outcome of willingness to use LAI PrEP as being very likely versus somewhat or not at all likely to use LAI PrEP, which is consistent with the categorization scheme for willingness to use PrEP that we have utilized ly [ 20 ].

All statistical analyses were conducted using SAS 9. One participant who did not know his willingness or preference was excluded from subsequent analyses. One participant who did not know his willingness was excluded. One participant who did not know his preference was excluded. Because HIV test were returned after completion of the behavioral survey after participants reported on willingness to use LAI PrEPwe were also able to specifically examine willingness among those who tested positive for HIV without having had knowledge of their serostatus.

In this sample, which was recruited using venue-based sampling and included a majority of men of color, high willingness to use LAI PrEP was more common than in studies of national samples of predominantly White MSM recruited using Internet-based methods: two Internet-based studies found that approximately half of participants were Local sex free latinas washington to use LAI PrEP in three-month dosing intervals, based on dichotomized measures of 5-point Likert scales [ 1415 ].

Although comparisons of proportions of participants who reported hypothetical willingness to use LAI PrEP across studies are inexact due to different survey measures and different study populations, it is promising that a majority of MSM in each of these studies reported being willing to use LAI PrEP.

Specifically, being less than 30 years old, having a greater of sexual partners in the last 12 months, and being newly identified as HIV-infected based on study testing were each independently associated with being very willing to use LAI PrEP, after adjusting for oral PrEP use. A study similarly found that young MSM with a greater of recent sexual partners and a diagnosis of a sexually transmitted infection were more likely to be willing to use LAI PrEP [ 16 ]. When men in another study were provided with these same response options plus two additional options—no preference or whichever is most effective—more participants expressed a preference for LAI PrEP than daily oral PrEP or whichever was most effective [ 15 ].

Despite inconsistencies across studies in overall percentages of participants who preferred various PrEP modalities, these taken together point to a large proportion of MSM who would prefer to receive periodic injections of long-acting agents as PrEP rather than take a daily oral pill.

This paradoxical finding might be explained by a greater mistrust of medical care in Black communities and a potentially more medicalized perception of injections relative to pills [ 2122 ]. Similarly, despite the fact that participants who were newly identified as HIV-infected were more likely to report being very willing to use LAI PrEP compared with participants who had non-reactive HIV testthose individuals were also paradoxically less likely to choose LAI PrEP to daily oral PrEP when asked about their preferred option, although this association was not ificant in multivariable analysis.

This finding warrants further evaluation and may in part be a consequence of the small absolute of participants who were newly identified as HIV-infected. If LAI PrEP is eventually approved as an HIV prevention intervention, PrEP candidates would still need to access health care, discuss PrEP with a health care provider, receive a prescription, and remain adherent to periodic clinic-based visits, which is analogous to the care continuum for receiving daily oral PrEP [ 23 ].

Known barriers to daily oral PrEP use among MSM and other populations include Local sex free latinas washington of knowledge of how to access PrEP, out-of-pocket costs, discomfort with disclosing sexual behavior to health care providers, concerns regarding short- and long-term side effects, low perceived personal susceptibility to contracting HIV, concerns about partial effectiveness of PrEP, and fear of risk compensation such as decreased use of condoms after initiating PrEP [ 524 — 27 ].

Although candidates for LAI PrEP would not have to adhere to a daily pill, they would have to adhere to regular clinic-based visits for periodic safety assessments and HIV testing. However, its dosing schedule is not yet finalized and LAI PrEP is currently being investigated as an injection administered every two months. It is important to acknowledge that we were unable to communicate the potential side effects of LAI PrEP or its actual efficacy, as from clinical trials of LAI PrEP were not yet available at the time of data collection.

Furthermore, participants in this study were recruited using venue-based sampling in a single city, so findings may not be generalizable to the general US population of MSM. Also, this study sample could generally access health care and demonstrated a high level of health-seeking behaviors. Despite these limitations, our assessment of willingness to use LAI PrEP among MSM in a high-prevalence setting can be useful for informing clinical development and potential future strategies to facilitate actual uptake.

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If LAI PrEP is proven to be efficacious in the clinical trial setting, its effectiveness in communities will depend on successful scale-up approaches that minimize costs and facilitate access for those individuals at greatest risk of infection. Future studies, including those utilizing qualitative research methods, should investigate more nuanced perceptions of LAI PrEP among MSM, including perceived potential barriers to uptake, as studies to date have generally used several closed-ended questions to measure interest in LAI PrEP.

Our findings provide reassuring evidence that the current biomedical HIV prevention agenda regarding LAI PrEP is focused on a novel prevention intervention that is likely to be acceptable among populations at greatest risk of HIV infection. This study could not have been conducted without the enormous support from our community partners and the generosity of our study participants in the District of Columbia. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Download: PPT. Table 1. Fig 1. Fig 2. Table 2. Acknowledgments This study could not have been conducted without the enormous support from our community partners and the generosity of our study participants in the District of Columbia.

References 1. Centers for Disease Control and Prevention. HIV Surveill Rep. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men.

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N Engl J Med. Preexposure prophylaxis for the prevention of HIV infection in the United States— clinical practice guideline. Unraveling the divergent of pre-exposure prophylaxis trials for HIV prevention. Sexual partnerships and considerations for HIV antiretroviral pre-exposure prophylaxis utilization among high-risk substance using men who have sex with men. Arch Sex Behav. Facilitators and barriers to medication adherence in an HIV prevention study among men who have sex with men in the iPrEx study in Chiang Mai, Thailand.

AIDS Care. Participant experiences and facilitators and barriers to pill use among men who have sex with men in the iPrEx pre-exposure prophylaxis trial in San Francisco.

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J Acquir Immune Defic Syndr. The promise and pitfalls of long-acting injectable agents for HIV prevention. Long-acting injectable antiretrovirals for HIV treatment and prevention. Preexposure prophylaxis modality preferences among men who have sex with men and use social media in the United States.

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PLoS One. Public Health Rep. Surveillance of HIV risk and prevention behaviors of men who have sex with men: a national application of venue-based, time-space sampling. View Article Google Scholar Willingness to use HIV pre-exposure prophylaxis among community-recruited, older people who inject drugs in Washington, DC. Drug Alcohol Depend. Journal of Psychological and Behavioral Science. The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men. Am J Public Health. Clin Infect Dis.

PrEP awareness and perceived barriers among single young men who have sex with men in the United States. Curr HIV Res. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations.

Attitudes and program preferences of African-American urban young adults about pre-exposure prophylaxis PrEP. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships.

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Trends in Sexual Risk Behaviors Among Hispanic/Latino Men Who Have Sex with Men — 19 Urban Areas, –