A survey of Swiss gay men and men who have sex with men recruited through the Grindr networking app has found that while only 4.3% had taken HIV pre-exposure prophylaxis (PrEP), 50% would consider taking it within the next six months and 79% would either take it some time in the future or want to learn more about it.
The survey was a brief one both in terms of its appearance online (from 5 to 24 January this year) and in terms of its length (only ten questions taking, it was estimated, a minute to answer on average). Of interest is the fact that GPS data was used to ensure that respondents were actually located in Switzerland, though it could not rule out non-residents. The survey ensured anonymity by redirecting participants to Surveymonkey to actually answer the survey and no identifying details were collected.
Of the 2455 men who answered at least one question, 1893 were included in the final analysis. Most were excluded because they did not answer enough questions, but 18 participants (1 in 136) said they were already HIV positive and were redirected to HIV services.
Eighty-two men said they had taken PrEP (4.3%). Of these, 17 (21%) said they had no medical supervision, and seven (9%) said they had not had an HIV test in the last year (30% of all respondents had not had a test in the last year).
Men who had taken PrEP were asked if they had obtained it from a hospital or local pharmacy, or if they had bought it online; there was a 50/50 split between pharmacy and online buyers.
The survey was conducted in the three main languages spoken in Switzerland and (on alternate days) in English. Men responding in Italian were both considerably less likely to have heard of PrEP (80% less likely than German or English speakers) and to have used it (only 70% less likely). Respondents using French were 33% less likely to have heard of PrEP than German or English speakers, but no less likely to have used it.
The median age of participants was 36 (inter-quartile range, 28-43); the youngest was 18 and the oldest 74. There may possibly have been younger respondents but Grindr requires users to state that they are over 18. Men over 50 were least likely to be interested in using PrEP and younger people somewhat more likely: under-20s were 20% more likely, 20-39 year olds 15-16% more likely and men in their forties 7% more likely than men over 50.
One question asked participants if they had any comments to add. There were 30 comments mentioning that the cost of PrEP in Switzerland was a barrier to its use. There were also 30 saying that that they would like more information on PrEP. Twenty-one comments cited concerns that the availability of PrEP might lead to an increase in sexually transmitted infections other than HIV, and another 21 had various moral concerns about using it. Twenty comments mentioned concerns about side-effects.
There has only been one previous survey of PrEP opinion in Switzerland, conducted in 2015 and published last year. In this 39% of respondents said they would be interested in using PrEP. A 2016 Europe-wide survey conducted by the European Centre for Disease Prevention and Control (ECDC) using the social app Hornet found that 31% said they were “very likely” to use PrEP in the next six months and 10% said they had already taken it. Another 2016 survey, Flash!PrEP, found that 44% were interested in taking PrEP and that 5% had already taken “informal” PrEP, i.e. not sourced through the healthcare system. Flash!PrEP was not just for gay men and while 62% of men had heard of PrEP, only 27% of women had. This Swiss survey, then, reports twice as much interest in PrEP as was seen in surveys from only a year ago.
Author: Gus Cairns