Amsterdam 2015
Amsterdam 2015
Abstract book - Abstract - 2284
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Abstract #2284  -  Biomedical prevention
Session:
  13.2: Biomedical prevention (Oral poster discussion) on Wednesday @ 13.30-14.30 in Poster room 2 Chaired by Catherine Hankins,
Sara Paparini

Authors:
  Presenting Author:   Prof Sibylle Nideröst - School of Social Work FHNW, Switzerland
 
  Additional Authors:   
Aim:
There are about 500 to 700 newly diagnosed HIV infections in Switzerland each year. Almost half of these are among men who have sex with men (MSM). Despite a wide range of interventions, this number has remained relatively stable during the past years. Thus the HIV Pre-Exposure-Prophylaxis (PrEP) is discussed as an additional prevention method targeting MSM. There is evidence from the USA that MSM are not as keen to use PrEP as expected. So far, PrEP has not been approved in Switzerland and little is known about the acceptability of PrEP among Swiss MSM. Therefore, the main objective of the study was to examine the acceptability of PrEP among MSM and to identify possible barriers to future adoption for HIV prevention.
 
Method / Issue:
During a 4-month period we conducted five focus group discussions with 23 consecutively sam-pled HIV-negative MSM aged 22 to 60 years living in Switzerland. The participants described themselves as gay, some as bisexual. Almost half of the participants reported being in a stable relationship with a male partner some of them were living in a serodiscordant relationship. The incomes of the participants ranged from no income to 15’000 CHF per month and their educational levels from completed vocational training to university degrees. Two focus group moderators with broad knowledge of the topic led through each discussion using a semi-structured interview guide. The focus group discussions were digitally recorded and fully transcribed. We analyzed the data according to qualitative content analysis using deductively and inductively developed categories.
 
Results / Comments:
The acceptability and future adoption of PrEP varied considerably among the participants. Some would use PrEP immediately after its introduction in Switzerland because it provides an alternative to condoms which they are unable or unwilling to use. Others were more ambivalent towards PrEP but still considered it 1) as an additional or alternative protection to regular condom use, 2) as an option to engage in sexual activities with less worries and anxieties or 3) as a protection during receptive anal intercourse independently of the sexual partners' protective behavior. However, some participants would not consider using PrEP as an option at all. They do not see any benefit in PrEP as they have adopted safer sex practices and do not have any problems with condom use. Others are still undecided and could imagine using an improved form of PrEP. The main barriers to future adoption of PrEP for HIV prevention seem to be the high costs, concerns about the efficacy, potential side effects, medical long-term effects, and the lack of protection against other sexually transmitted infections.
 
Discussion:
The results provide a valuable basis for a model explaining the acceptability of PrEP among MSM. In a next step, the relevance of the identified factors will be tested in a quantitative follow-up study. The results are contributing significantly to the discussion concerning the introduction of PrEP in Switzerland and its anticipated effects on HIV prevention.
 
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