Factors associated with the intention to use HIV Pre-exposure Prophylaxis for young and older men who have sex with men

INTRODUCTION: The uptake of pre-exposure prophylaxis (PrEP) against HIV is low among young men who have sex with men (MSM) in the Netherlands. Studying the intention to use PrEP among non-PrEP using young and older MSM can guide health authorities in developing new prevention campaigns to optimize PrEP uptake.METHODS: We investigated the sociodemographic, behavioral and psychosocial factors associated with a high PrEP use intention in the coming six months, among 93 young MSM (YMSM; aged ≤25 years), participating in an online survey, and 290 older MSM (aged ≥26 years), participating in an open, prospective cohort in 2019-2020.RESULTS: Perceiving PrEP as an important prevention tool was associated with a high PrEP use intention among young and older MSM. Among YMSM, a high level of PrEP knowledge, and believing that PrEP users take good care of themselves and others was associated with a high PrEP use intention. Among older MSM, two or more anal sex partners, chemsex, high HIV risk perception, and believing PrEP increases sexual pleasure was associated with a high PrEP use intention. Believing PrEP leads to side-effects was associated with a low intention to use PrEP among older MSM.DISCUSSION: To conclude, we showed that both behavioral and psychosocial factors were associated with a high PrEP use intention among young and older MSM. In addition to focusing on sexual behavior and HIV risk, future prevention campaigns and counseling on PrEP could incorporate education, endorsing positive beliefs and disarming negative beliefs to improve the uptake of PrEP in young and older MSM.