Identifying Patterns of Discontinuing and Recommencing Pre-exposure Prophylaxis in the Context of Sexual Behavior Among Gay and Bisexual Men in Australia

We mapped gay and bisexual men’s (GBM) patterns of using pre-exposure prophylaxis (PrEP) over time and explored sexual behavior as PrEP use changed. We conducted semi-structured interviews between June 2020 and February 2021 with 40 GBM living in Australia who had changed their PrEP use since initia...

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Bibliographic Details
Published in:AIDS and behavior 2023-09, Vol.27 (9), p.2891-2901
Main Authors: Philpot, Steven P., Murphy, Dean, Chan, Curtis, Haire, Bridget, Wells, Nathanael, Fraser, Doug, Grulich, Andrew E., Bavinton, Benjamin R.
Format: Article
Language:English
Subjects:
Anal intercourse
Behavior modification
Bisexuality
Condoms
Disease prevention
Health education
Health promotion
Health Psychology
Health risks
Health services
HIV
Homosexuality
Human immunodeficiency virus
Infectious Diseases
Medicine
Medicine & Public Health
Original Paper
Prophylaxis
Public Health
Risk
Risk management
Risk reduction
Safe sexual practices
Sex
Sexual behavior
Sexual intercourse
Sexually transmitted diseases
STD
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Summary:We mapped gay and bisexual men’s (GBM) patterns of using pre-exposure prophylaxis (PrEP) over time and explored sexual behavior as PrEP use changed. We conducted semi-structured interviews between June 2020 and February 2021 with 40 GBM living in Australia who had changed their PrEP use since initiating. There was considerable diversity in patterns of discontinuation, suspension, and recommencement of PrEP. Reasons for changing PrEP use mostly centered on accurate perceived changes to HIV risk. Twelve participants reported condomless anal intercourse with casual or fuckbuddy partners after discontinuing PrEP. These sex events were unanticipated, condoms were not a preferred option, and other risk reduction strategies were applied inconsistently. Service delivery and health promotion can support safer sex among GBM when PrEP use fluctuates by promoting event-driven PrEP and/or non-condom-based risk reduction methods during periods off daily PrEP, and guiding GBM to better recognize changing circumstances of risk and when to recommence PrEP.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-023-04013-3