Open AccessSalient Constructs for the Development of Shared Decision-Making Tools for HIV Pre-Exposure Prophylaxis Uptake and Regimen Choice: Behaviors, Behavioral Skills, and Beliefs
Author(s) -
Kathrine Meyers,
Yumeng Wu,
Kee-Young Shin,
Junlin Hou,
Qinghai Hu,
Junyi Duan,
Yao Li,
Xiaoqing He
Publication year - 2021
Publication title -
aids patient care and stds
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.504
H-Index - 85
eISSN - 1557-7449
pISSN - 1087-2914
DOI - 10.1089/apc.2021.0066
Subject(s) - pre exposure prophylaxis , regimen , medicine , decision aids , preference , human immunodeficiency virus (hiv) , family medicine , odds , logistic regression , men who have sex with men , clinical psychology , alternative medicine , syphilis , pathology , economics , microeconomics
The availability of multiple pre-exposure prophylaxis (PrEP) regimens creates a preference-sensitive choice for individuals weighing alternative HIV prevention strategies. Investigating factors that are associated with PrEP uptake and regimen choice are key to developing tools to support that decision. A cross-sectional survey was offered to 536 participants in a PrEP demonstration project for gay, bisexual, and other men who have sex with men across 3 cities in China, of which 412 completed surveys and were included in the analysis. We conducted bivariable analyses followed by multi-variable logistic regressions to examine factors associated with overall PrEP uptake and PrEP regimen choice. Among the 412 participants, 36.9% were daily PrEP users, 28.4% were event-driven users, and 34.7% were non-PrEP users. Higher levels of education, lower PrEP use stigma, and higher perceived benefits of PrEP were associated with greater PrEP uptake. More frequent sex, higher PrEP adherence self-efficacy, higher endorsement of the belief in elevated efficacy of daily over on-demand PrEP, and lower endorsement of a desire for a PrEP method that is only taken when needed led to greater odds of choosing the daily PrEP regimen. As multiple HIV prevention modalities become available, there is a greater need for a shared decision-making approach to support this preference-sensitive choice of HIV prevention method. Our findings suggest salient constructs to inform the development of shared decision-making tools to support regimen choice.