XIX International AIDS Conference

TUAC03 Antiretroviral Prophylaxis: Attitudes and Implementation
  Oral Abstract Session : Track C
Venue: Session Room 3
Time: 24.07.2012, 14:30 - 16:00
Co-Chairs: Ying-Ru Lo, Switzerland
Dawn K. Smith, United States

HIV-negative and HIV-positive gay men's attitudes towards antiretroviral-based prevention: similar attitudes to pre-exposure prophylaxis (PrEP) but greater scepticism among HIV-negative men about 'treatment as prevention'
M. Holt1, D. Murphy1,2, D. Callander1, J. Ellard1, M. Rosengarten3, S. Kippax4, J.B.F. de Wit1,5
1The University of New South Wales, National Centre in HIV Social Research, Sydney, Australia, 2Australian Federation of AIDS Organisations, Sydney, Australia, 3Goldsmiths, Department of Sociology, London, United Kingdom, 4The University of New South Wales, Social Policy Research Centre, Sydney, Australia, 5Utrecht University, Department of Social and Organizational Psychology, Utrecht, Netherlands
M. Holt, Australia

Anticipated risk compensation with pre-exposure prophylaxis use among North American men who have sex with men using an internet social network
D. Krakower1, M. Mimiaga2, J. Rosenberger3, D. Novak4, J. Mitty5,6, J. White6, K. Mayer5,6
1Beth Israel Deaconess Medical Center, Division of Infectious Diseases, Boston, United States, 2Fenway Health / Harvard School of Public Health / Harvard Medical School, Boston, United States, 3George Mason University, Fairfax, United States, 4Online Buddies, Inc., Cambridge, United States, 5Beth Israel Deaconess Medical Center/ Harvard Medical School, Boston, United States, 6Fenway Health, Boston, United States
D. Krakower, United States

Acceptability of HIV pre-exposure prophylaxis (PrEP) with Truvada among men who have sex with men (MSM) and male-to-female transgender persons (TG) in northern Thailand
D. Yang1,2, C. Chariyalertsak3, A. Wongthanee2, S. Kawichai1,2, K. Yotruean3, T. Guadamuz4,5, V. Suwanvanichkij1, C. Beyrer1, S. Chariyalertsak2
1Johns Hopkins Bloomberg School of Public Health, Baltimore, United States, 2Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand, 3Chiang Mai Provincial Health Office, Thailand MOPH, Chiang Mai, Thailand, 4Mahidol University, Center for Health Policy Studies, Bangkok, Thailand, 5University of Pittsburgh Graduate School of Public Health, Pittsburgh, United States
D. Yang, United States

Dentist's willingness to offer oral HIV rapid testing: results from a nationally representative survey
L.R. Metsch1, H.A. Pollack2, S. Abel3, C. Kunzel4, B. Greenberg5, S. Messinger1, M. Pereyra1
1University of Miami Miller School of Medicine, Department of Epidemiology and Public Health, Miami, United States, 2University of Chicago, School of Social Service Administration, Chicago, United States, 3Nova Southeastern University, College of Dental Medicine, Ft. Lauderdale, United States, 4Columbia Mailman School of Public Health, Sociomedical Sciences, New York, United States, 5New Jersey Medical School, UMDNJ, New Jersey Dental School, Newark, United States
L. Metsch, United States

Powerpoints presentations
Acceptability of HIV pre-exposure prophylaxis (PrEP) with Truvada among men who have sex with men (MSM) and male-to-female transgender persons (TG) in northern Thailand - Daniel Yang

Rapporteur report

Track C report by Albert Liu

This session addressed attitudes and implementation issues for antiretroviral prophylaxis and HIV rapid testing.

Attitudes towards antiretroviral-based prevention were compared in 1,283 HIV-negative and HIV-positive gay men in a national online survey in Australia.  HIV-negative and HIV-positive gay men had similar attitudes towards PrEP, including beliefs that PrEP is effective in preventing HIV, that it would make people less responsible, that it should be provided free of charge, and is less effective than condoms.  HIV-positive men agreed, while HIV-negative men disagreed, that taking HIV treatments was straightforward.  HIV-negative men were particularly skeptical that being on ART/having an undetectable viral load prevented HIV transmission.

In a North American online survey of an internet survey of 5,035 HIV-uninfected MSM, 19% had heard of PrEP, and approximately half stated they would use daily PrEP.  While using PrEP, a substantial minority anticipated they would decrease their condom use for insertive (20%) or receptive (14%) anal sex.  Recent unprotected anal sex, greater self-perceived risk for HIV acquisition, and substance use were associated with anticipated risk compensation, and MSM with these characteristics may benefit from more intensive counseling.

PrEP acceptability was also evaluated in a survey of 131 MSM and 107 transgender (TG) women in northern Thailand.  Prior awareness of PrEP was high among both groups (66%).  PREP acceptability was 41% in MSM and 37% in TG, assuming PrEP were 50% effective.  Factors associated with PrEP acceptability in MSM included a lifetime history of STIs, previous HIV testing, and infrequent and planned sex, and in TG included prior awareness of PrEP and having private insurance.  Educational campaigns, expanded HIV testing services, and financial subsidies may increase future uptake of PrEP in this region.

Finally, dental care settings may be a promising venue for HIV screening of otherwise untested individuals.  In a nationally representative sample of dentists in the US, the majority (63%) were willing to offer the oral HIV rapid test, but less than half (46%) believed HIV testing should be part of the dentist’s role.  Willingness to offer rapid testing was associated with dentists’ positive attitude regarding patient acceptance of testing (AOR=3.4), agreement that all persons at high risk should be tested annually (AOR=1.66), and belief that their colleague’s perception of them would improve if HIV testing was offered (AOR=2.68).  Audience discussion highlighted the importance of linkage to care services for those who test positive and included questions on how dentists would use (or be influenced by) HIV test results in the care of their patients.


    The organizers reserve the right to amend the programme.

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