Preferences and willingness to use pre-exposure prophylaxis for HIV among men who have sex with men in mainland China and Hong Kong
Background Pre-exposure prophylaxis (PrEP) uptake remains low in mainland China and Hong Kong. We examined preferences for different PrEP modalities among men who have sex with men (MSM) in mainland China and Hong Kong. Methods We conducted a cross-sectional online survey from May to November 2022 in mainland China and Hong Kong. Eligible participants were aged ≥18years, identified as MSM and self-reported HIV-negative, or unknown HIV status. Random forest models and SHapley Additive exPlanations analyses were used to identify key factors influencing preferences for and willingness to use six PrEP options: (1) daily oral, (2) on-demand oral, (3) monthly oral, (4) two-monthly injectable, (5) six-monthly injectable, and (6) implantable PrEP. Results Among 2142 participants (mainland China: 1604; Hong Kong: 538), the mean age was 28.4 (±7.0) years in mainland China and 34.7 (±9.5) years in Hong Kong. Current PrEP use was similar between mainland China and Hong Kong (18.0% vs 17.8%, P =0.93), with an additional 10.5% and 8.0% reporting past PrEP use (P =0.11), respectively. A greater proportion of participants from mainland China preferred on-demand PrEP compared to those from Hong Kong (55.7% vs 48.1%, P P =0.02). Willingness to use non-oral options was lower, with two-monthly injectable PrEP preferred by 21.1% (19.1-23.1%) in mainland China and 15.4% (12.3-18.5%) in Hong Kong (P Conclusions On-demand and monthly PrEP options remain the preferred choices, though the monthly oral option is neither proven nor available. However, the factors influencing these preferences vary, highlighting the need for tailored and targeted approaches to PrEP implementation.
Authors
- Edmond Pui Hang Choi (ORCID: https://orcid.org/0000-0001-9062-3540)
- Michael Cassell
- Nicky Suwandi
- Douglas Fraser (ORCID: https://orcid.org/0000-0003-4521-4697)
- Jason J. Ong (ORCID: https://orcid.org/0000-0001-5784-7403)
- Curtis Chan (ORCID: https://orcid.org/0000-0002-9581-1011)
- Warittha Tieosapjaroen (ORCID: https://orcid.org/0000-0001-9712-9262)
- Kimberly E. Green (ORCID: https://orcid.org/0000-0002-0848-8480)
- Jiajun Sun (ORCID: https://orcid.org/0000-0001-5529-6660)
- Benjamin R. Bavinton (ORCID: https://orcid.org/0000-0001-5834-8278)
- Nittaya Phanuphak (ORCID: https://orcid.org/0000-0002-0036-3165)
- Midnight Poonkasetwattana
- Heather-Marie Ann Schmidt (ORCID: https://orcid.org/0000-0002-2629-6407)
- Weiming Tang (ORCID: https://orcid.org/0000-0002-9026-707X)
- Hua Boonyapisomparn
- Lei Zhang (ORCID: https://orcid.org/0000-0003-2343-084X)
Institutions
- University of North Carolina at Chapel Hill (US)
- University of London (GB)
- Family Health International 360 (US)
- Joint United Nations Programme on HIV/AIDS (CH)
- Chulalongkorn University (TH)
- UNSW Sydney (AU)
- London School of Hygiene & Tropical Medicine (GB)
- Melbourne Sexual Health Centre (AU)
- World Health Organization (CH)
- HIV Netherlands Australia Thailand Research Collaboration (TH)
- New South Wales Institute of Psychiatry (AU)
- Second Affiliated Hospital of Xi'an Jiaotong University (CN)
- Network of Aquaculture Centres in Asia-Pacific (TH)
- Apicha Community Health Center (US)
- Hanoi School Of Public Health (VN)
- Monash University (AU)
- Xi'an Jiaotong University (CN)
- University of Hong Kong (HK)
Publication Details
- Journal
- Sexual Health
- Published
- 2025-05-25
- DOI
- https://doi.org/10.1071/sh24247
- Citations
- 2
- Primary Topic
- HIV/AIDS Research and Interventions
- Type
- article
- Field-Weighted Citation Impact
- 2.79
Funders
- FHI 360
- Ministry of Science and Technology of the People's Republic of China
- National Health and Medical Research Council
- National Key Research and Development Program of China
- Australian Research Centre in Sex, Health and Society, La Trobe University