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Use of HIV pre-exposure prophylaxis (PrEP) associated with lower HIV anxiety among gay and bisexual men in Australia who are at high risk of HIV infection

Results from the Flux Study.

Keen, Phillip1; Hammoud, Mohamed A.1; Bourne, Adam2; Bavinton, Benjamin1; Holt, Martin3; Vaccher, Stefanie1; Haire, Bridget1; Saxton, Peter4; Jin, Fengyi1; Maher, Lisa1; Grulich, Andrew E.1; Prestage, Garrett1

JAIDS Journal of Acquired Immune Deficiency Syndromes: November 20, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/QAI.0000000000002232
Original Article: PDF Only

Background: Many gay and bisexual men (GBM) experience HIV anxiety, particularly around condomless anal intercourse (CLAI). HIV pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy that may reduce HIV anxiety among GBM.

Methods: The Following Lives Undergoing Change (Flux) Study is a national, online, open prospective observational study of licit and illicit drug use among GBM in Australia. In 2018, participants responded to newly included items regarding anxiety about HIV transmission. Stratifying GBM as high or low risk as determined by the Australian PrEP Guidelines, we assess whether PrEP use is associated with lower levels of HIV anxiety. Multivariate logistic regression was used to compare factors associated with PrEP use among GBM at high risk (PrEP-eligible) and low risk (PrEP-ineligible) of HIV infection. Results are reported as adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI).

Results: Among 1547 men, mean age was 37.1 years (SD 13.1). Men aged 25 years or younger had higher HIV anxiety scores than older men. Among PrEP-eligible men, men who use PrEP reported lower levels of HIV anxiety (aOR=0.92; 95%CI=0.87-0.99; p<0.001). No differences were observed on HIV anxiety among PrEP-ineligible men.

Conclusions: Among PrEP-eligible men, PrEP use was independently associated with lower levels of HIV anxiety. In addition to avoiding HIV infection, PrEP use may help reduce anxiety among men at risk of HIV. This feature of PrEP could be promoted as part of demand creation initiatives to increase PrEP uptake.

1The Kirby Institute, UNSW Sydney, Sydney, Australia

2Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne

3Centre for Social Research in Health, UNSW Sydney

4Department of Social and Community Health, School of Population Health, University of Auckland, New Zealand

Corresponding author:

The authors report no conflicts of interest related to this work.

Funding statement: The Flux Study is funded by an Australian Research Council Discovery Project. In 2018, this study was partly funded by the Gilead Australia Fellowship: Research Grants Program. Gilead Australia Fellowship had no input in the data collection, analysis, interpretation, or presentation of any findings.

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