Adding to the HIV Prevention Toolkit: High Interest in a Long-Acting Injectable Formulation of Pre-Exposure Prophylaxis in a Cohort of Young Men who have Sex with Men in NYC

Background:  In the context of continued high rates of HIV-1 infection, particularly in high-risk populations such as young MSM(YMSM) of color, additional effective and desirable HIV prevention tools are needed.  The efficacy of daily oral PrEP has ranged widely across clinical trials due to variable adherence. Long-acting injectable PrEP(LAI-PrEP) could circumvent adherence challenges, however, desirability and acceptability of such an agent has not yet been assessed among target populations in the US.

Methods:  Between May-August 2013, a cross-sectional study was conducted with a racially/ethnically diverse cohort of YMSM in NYC. Three outcome measures were assessed: 1) willingness to use LAI-P; 2) preference for route of administration; and 3) major concerns with LAI-PrEP.  

Results:  Of 197 YMSM (74.1% of color), 80% responded that they would definitely/probably try LAI-P and 85.7% preferred injection every three months over daily oral administration. No difference in interest and preference was seen across groups by race/ethnicity, socioeconomic status, education, or risk behavior. Major concerns around LAI-P were side effects (87.8%,n=173), long-term health effects (85.8%,n=169) and uncertainty of drug’s effectiveness (83.3%,n=164). In addition, personal concerns such as risk disinhibition and stigma were noted: 47.2% stated they might be more likely to reduce their condom use if taking PrEP and 28.4% worried they would be mistaken as HIV-infected.

Conclusions:  This study is the first to explore acceptability of LAI-P in the US. The significant preference for LAI-P over daily oral PrEP across all groups suggests that a LAI product would be a welcome addition to the prevention toolkit.