Factors Associated with Not Seeking Post-exposure Prophylaxis for HIV Among PrEP-Naive Men Who Have Sex with Men: An Analysis from the French ANRS-PREVENIR Study
HIV post-exposure prophylaxis (PEP) uptake is low among men who have sex with men (MSM), even among those aware of it. We examined factors associated with not seeking PEP among MSM in the ANRS-PREVENIR cohort who were PrEP-naive at enrollment, aware of PEP, and reported a potential need for it in the previous 12 months. Among 3,193 participants, 632 (19.8%) met these criteria, and 424 (67.1%) did not seek PEP. The most cited reasons were low perceived HIV risk, fear of judgment or stigmatization, and reluctance to seek hospital-based care. In multivariable analyses, living alone, perceived sexual risk, awareness of a partner's HIV status, high alcohol consumption, and engagement in 'hardcore sexual' practices were associated with higher odds of not seeking PEP, whereas frequent HIV testing and prior mental health consultation were associated with lower odds. These findings highlight the need to address individual and structural barriers to PEP uptake.
Authors
- Marie Costa (ORCID: https://orcid.org/0000-0001-7360-1921)
- Jade Ghosn (ORCID: https://orcid.org/0000-0003-2914-959X)
- Dominique G. Costagliola (ORCID: https://orcid.org/0000-0003-0765-0869)
- Christel Protière (ORCID: https://orcid.org/0000-0002-5602-9617)
- Mohamed Ben-Mechlia
- Lydie Béniguel
- Bruno Spire (ORCID: https://orcid.org/0000-0002-3546-8020)
- Luis Sagaon‐Teyssier (ORCID: https://orcid.org/0000-0001-7318-6596)
- Lambert Assoumou (ORCID: https://orcid.org/0000-0002-5547-1796)
- David Michels (ORCID: https://orcid.org/0009-0001-2230-0173)
- Victoria Manda (ORCID: https://orcid.org/0009-0003-9328-9535)
- Adbourahmane Sow (ORCID: https://orcid.org/0000-0002-2840-0132)
- Juan Camilo Jones (ORCID: https://orcid.org/0009-0004-7202-4738)
Institutions
- Délégation Paris 5 (FR)
- Schneider Electric (France) (FR)
- Inserm (FR)
- Université Paris Cité (FR)
- Sorbonne Université (FR)
- Sorbonne Paris Cité (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre d'Immunologie et des Maladies Infectieuses (FR)
- Institut Pierre Louis d‘Épidémiologie et de Santé Publique (FR)
- Long Term Care Community Coalition (US)
- Hôpital Bichat-Claude-Bernard (FR)
- Economic & Social Sciences, Health Systems & Medical Informatics (FR)
- Institut de Recherche pour le Développement (FR)
Publication Details
- Journal
- AIDS and Behavior
- Published
- 2026-04-28
- DOI
- https://doi.org/10.1007/s10461-026-05131-4
- Primary Topic
- HIV/AIDS Research and Interventions
- Type
- article
- Field-Weighted Citation Impact
- 0.00