Background: Pre-exposure prophylaxis (PrEP) is a biomedical prevention strategy with significant potential to reduce HIV incidence among MSM worldwide. In 2018, the ImPrEP Project began in Mexico, a preliminary step for the launch of comprehensive PrEP services in that country. However, little data exists about PrEP engagement among MSM in Mexico. We sought to understand correlates of PrEP knowledge, intention, and uptake among an online sample of MSM in Mexico in order to guide future PrEP intervention efforts.
Methods: Between November 2018 and January 2019 we recruited MSM from the social networking application, Hornet, using targeted advertising (N=2,957). Participants completed a brief online survey, which assessed PrEP knowledge, intention to use PrEP in the next 6 months, and current PrEP use. Bivariate tests of association, followed by multivariable logistic regression analyses, were used to determine correlates of these three PrEP-related outcomes, sociodemographic characteristics and behavioral health variables.
Results: HIV-positive MSM (N=490; 16.6%) were excluded, leaving a total analytic sample of 2,467. Over two-thirds (70.0%) had previous knowledge about PrEP; 35.7% intended to use PrEP in the next 6 months; and 3.48% were current PrEP users. Of those currently using PrEP, the majority obtained the medication from their doctors (51.1%); a smaller percentage obtained the medication from a research study (25.0%), friends (7.9%), the internet (11.3%) or another source (4.5%). Mutivariable analyses demonstrated that PrEP use was associated with prior sexually transmitted infection testing (aOR: 6.67, CI: 4.12-10.77), and satisfaction with sex life (aOR: 1.37 , CI: 1.16-1.60 ). PrEP intention was associated with using the “know your status” function on Hornet (aOR: 2.17, CI: 1.76-2.68), and sex life satisfaction (aOR: 1.19, CI: 1.05-1.33).
Conclusions: PrEP use among Mexican MSM in our sample was low; however, knowledge of and intention to use PrEP were high, representing an important opportunity for HIV prevention. Geosocial networking apps and STI testing centers may be leveraged for PrEP information dissemination and PrEP access among MSM in Mexico. PrEP users in our sample were more satisfied with their sex lives than non-PrEP users; highlighting this may be helpful to increasing PrEP uptake among Mexican MSM.