Correlation between sexual behavior and preferences for HIV pre-exposure prophylaxis modality among men who have sex with men: a cross-sectional analysis

Demographic, behavioral, and clinical characteristics have been found to be associated with willingness to use and preferences for different HIV pre-exposure prophylaxis (PrEP) modalities. Limited data are available, however, describing how sexual behavior characteristics affect willingness to use and preferences for PrEP. Given the different clinical characteristics of available PrEP modalities (i.e., daily oral, on-demand oral, long-acting injectable), an individual's sexual behavior (i.e., number of partners, partner characteristics) might affect their preferences for PrEP. We conducted a cross-sectional study among men who have sex with men (MSM) who are not living with HIV to assess the association between willingness to use PrEP and preferences for three different PrEP modalities with key sexual behavior characteristics. We found that willingness to use PrEP was not strongly associated with sexual behavior; however, for each sexual behavior characteristic we examined, preferences were higher for each modality of PrEP compared to no PrEP. As the number of sexual partners in the past 12 months increased, so did preferences for each modality of PrEP compared to no PrEP. Preferences were consistently stronger for injectable compared to oral PrEP. These results indicate that PrEP preferences are responsive to sexual behavior.