JMIR Publications

ABSTRACT

Background:

Despite recent advances, pre-exposure prophylaxis (PrEP) scale-up remains slow in Latin America. Understanding PrEP modality preferences can help design effective implementation.

Objective:

The aim of this study was to describe willingness to use different PrEP modalities among sexual and gender minorities (SGM) aged 18+ years from Brazil, Mexico and Peru, and factors associated with willingness to use four PrEP modalities.

Methods:

We conducted a cross-sectional online survey in 2021. We used multivariate Poisson regression to estimate prevalence ratios, identifying differences in willingness to use daily oral, event-driven oral, monthly oral and bimonthly injectable PrEP. Models for each PrEP modality were adjusted for age, country, race, education, income, HIV risk score, HIV testing, and HIV risk perception.

Results:

Among 27,589 individuals who initiated the survey, 16,951 were included (Brazil: 61.3%; Mexico: 29.5%; Peru: 9.3%). Mean age was 32 years, and 67.8% had more than secondary education. Most respondents were willing to use monthly oral (74.4%), daily oral (65.8%), and bimonthly injectable (60.2%), while only 38.0% were willing to use event-driven oral PrEP. Across modalities, willingness was higher among those with increased HIV risk perception and high HIV sexual exposure. Willingness was lower among Peruvian respondents for all modalities, except event-driven PrEP. Participants with lower education had lower willingness to use monthly oral and bimonthly injectable PrEP.

Conclusions:

Our results suggest a preference for long-acting formulations among SGM in Latin America. Further research is needed to address gaps in the understanding of prevention modalities and to guide potential users in selecting the most suitable PrEP modality available.