JMIR Publications

ABSTRACT

Background:

Investigation of community awareness of HIV functional cure has often been restricted to people living with HIV. An understanding of the attitude of men who have sex with men (MSM) in the community is important as it contributes to the supportiveness of curative treatment in the community.

Objective:

This study aims to profile the attitude of HIV functional cure among MSM not living with HIV.

Methods:

This is a secondary analysis of a community-based survey with recruitment of MSM aged 18 or above in Hong Kong for an online survey. MSM who self-reported HIV negative were targeted in the analyses. Positive attitude towards functional cure (outcome variable) was defined as the intersection of awareness, full score on excitement level, and trial participation willingness. Factors associated with positive attitude were examined in bivariable logistic regression. To understand the diversity of attitude towards functional cure, these dimensions and interpretations of cure were delineated by latent class analysis (LCA).

Results:

A total of 712 MSM were recruited in September 2021 – October 2022. a majority of whom were Chinese, single and in employment. In 541 MSM self-reported not having tested positive for HIV, 16% showed positive attitude towards functional cure. The latter were more likely to report history of STI diagnosis (odds ratio, OR=2.15), group sex engagement (OR=1.82), sex partner networking in gay saunas (OR=1.93), and having at least 1 sex partners with HIV (OR=3.84). Four latent classes were identified: Class 1 (n=40, 7%) showed high excitement and had strongly positive attitude with broad consideration of full advantages of cure; all in Class 2 (n=247, 46%) considered that no life-long medicine would be required; higher proportion in Class 3 (n=153, 28%) considered that HIV positive marker would no longer be present; and higher proportion in Class 4 (n=101, 19%) perceived functional cure as being likened to “immune” to HIV.

Conclusions:

The proportion of MSM without HIV infection having strongly positive attitude towards functional cure was not high. There is a diverse spectrum of interpretations towards functional cure in the MSM community, which may have affected their supportiveness of curative treatment.