Awareness and intention to use event-driven and long-acting injectable pre-exposure prophylaxis among adolescent and young men who have sex with men and transgender women in Brazil

Abstract

Abstract Background We aimed to investigate awareness and intention to use event-driven (ED-PrEP) and long-acting injectable pre-exposure prophylaxis (LAI-PrEP) and associated factors among adolescents and young men who have sex with men (AYMSM) and young transgender women (AYTGW). Methods A cross-sectional study with this population aged 15–20 years from the PrEP1519 project, a cohort study on daily oral PrEP in Brazil. The outcome variables were the intention to use ED-PrEP and LAI-PrEP. Adjusted odds ratios were estimated using binomial logistic regression. Results Only 15·3% and 18·0% of the adolescents were aware of the ED-PrEP and LAI-PrEP options, respectively, with 56·4% reporting intention to use ED-PrEP and 81·5% intention to use LAI-PrEP. Adolescents with low adherence to daily oral PrEP were more likely to intend to use ED-PrEP; however, those who reported always/oftently using condoms in insertive anal sex with steady or casual partners were less likely to intend to use ED-PrEP. As for LAI-PrEP, those reporting middle or low socioeconomic status and three or more casual partners in the previous three months were more likely to intend to use LAI-PrEP. Adolescents who never used daily oral PrEP were less likely to intend to use LAI-PrEP. Conclusions AYMSM and AYTGW in Brazil expressed a greater intention to use LAI PrEP over ED-PrEP, and their sexual behavior pattern strongly influenced their choice of the method. These prevention products mean that there are additional options. Improving choice can potentially increase PrEP uptake and use.