Knowledge and concerns about pre-exposure prophylaxis, sexual transmitted infections and antibiotic resistance amongst gay and bisexual men in Wales: a qualitative study

Conference:

SAPC ASM 2021 - virtual

Talk Code:

P1.28.2

Presenter:

Adam Williams

Twitter:

@adamdalenewman1

Co-authors:

Dr David Gillespie1, Dr Fiona Wood2, Dr Kathryn Hughes2, Zoë Couzens3, Prof Kerenza1 Hood

Author institutions:

1.Centre for Trials Research, Cardiff University., 2.Division of Population Medicine, Cardiff University., 3.Public Health Wales NHS Trust

Problem

Since the introduction of HIV pre-exposure prophylaxis (PrEP) in 2012 there have been concerns raised around the potential impact of risk compensation. Some fear that the provision of PrEP would result in an elevation in sexually transmitted infections (STIs) through reduced condom use. With the rising number of resistant strains of STIs it is concerned that PrEP may contribute to its growth. There is no conclusive evidence supporting the increase of STIs due to PrEP, with identifying and measuring risk compensation complex. PrEP has been available through the NHS in Wales since 2017 and largely been targeted at men who have sex with men. This work aims to understand the knowledge around PrEP, STIs and antibiotic resistance amongst men who have sex with men as well as their views about the relationships that may exist between the variables.

Approach

Semi-structured interviews were carried out via video calls (initially intended to be face to face but changed in response to the pandemic). Participants included a mix of current PrEP users, individuals who had started but recently stopped using PrEP and those who had never used PrEP. Interview questions were developed with input from academics and stakeholders. Questions were focused around gaining insight of knowledge and personal experiences related to focus points (PrEP, STIs, antibiotic resistance). Question probes related to the condom use behaviours and suggestions for interventions. All interviews ended with questions related to the impact of COVID-19 and lockdown measures on behaviour. Interviews were professionally transcribed to be thematically analysed. Coding for all interviews was completed by the lead author with 10% double coded to assess validity and reliability.

Findings

Twenty interviews were conducted between 15th June 2020 and 11th February 2021. Participants were located across Wales with the majority being from Cardiff and ages ranged from 19 to 53 years. Half of participants were current PrEP users, the other 10 contained a mix of those who had stopped and those who had never used PrEP.

[Analysis ongoing] Themes include……key experiences were…. The impact of the COVID-19 pandemic on behaviour will also be described.

Consequences

These findings will provide a detailed account of the perceived impact of PrEP on condom use behaviours and STIs, along with knowledge of the variables amongst MSM in Wales. Along with providing suggested interventions to improve sexual health among this cohort.

Submitted by:

Adam Williams

Funding acknowledgement:

Knowledge Economy Skills Scholarships (KESS 2) is a pan Wales higher level skills initiative led by Bangor University on behalf of the HE sector in Wales. It is part funded by the Welsh Government’s European Social Fund (ESF) convergence programme for West Wales and the Valleys.