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Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis

PrEP uptake in the Netherlands is growing but remains at suboptimal levels. Hence, the analysis of hurdles is paramount. Given the initial focus of PrEP provision among men-who-have-sex-with-men (MSM) via a demonstration project that was launched in June 2015, AmPrEP in Amsterdam, and pharmacies in...

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Autores principales: Wang, Haoyi, Shobowale, Oladipupo, den Daas, Chantal, Op de Coul, Eline, Bakker, Bouko, Radyowijati, Aryanti, Vermey, Koenraad, van Bijnen, Arjan, Zuilhof, Wim, Jonas, Kai J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315833/
https://www.ncbi.nlm.nih.gov/pubmed/35886681
http://dx.doi.org/10.3390/ijerph19148829
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author Wang, Haoyi
Shobowale, Oladipupo
den Daas, Chantal
Op de Coul, Eline
Bakker, Bouko
Radyowijati, Aryanti
Vermey, Koenraad
van Bijnen, Arjan
Zuilhof, Wim
Jonas, Kai J.
author_facet Wang, Haoyi
Shobowale, Oladipupo
den Daas, Chantal
Op de Coul, Eline
Bakker, Bouko
Radyowijati, Aryanti
Vermey, Koenraad
van Bijnen, Arjan
Zuilhof, Wim
Jonas, Kai J.
author_sort Wang, Haoyi
collection PubMed
description PrEP uptake in the Netherlands is growing but remains at suboptimal levels. Hence, the analysis of hurdles is paramount. Given the initial focus of PrEP provision among men-who-have-sex-with-men (MSM) via a demonstration project that was launched in June 2015, AmPrEP in Amsterdam, and pharmacies in the main urban areas (so called “Randstad”, entailing Amsterdam, Utrecht, Leiden, The Hague and Rotterdam), investigating regional differences is necessary. This study seeks to unravel regional differences jointly with the psycho-social determinants of PrEP uptake. This cross-sectional study included 3232 HIV-negative MSM recruited via the Dutch subsample of the European-MSM-Internet-Survey in late 2017 (EMIS-2017), which aimed to inform interventions for MSM who are highly affected by infections with HIV and other sexually transmitted infections. Prevalence and the standardised prevalence ratio (SPR) of PrEP awareness, intention and uptake were measured on a regional level (Randstad vs. the rest of the country). Multi-level logistic modelling was conducted to identify the association of PrEP uptake with PrEP awareness and intention, socio-demographic, psycho-social determinants and random effects from regional differences. MSM from the Randstad used more PrEP (SPR = 1.4 vs. 0.7) compared to the rest of the country, but there were minor differences for awareness and intention. The regional distinction was estimated to explain 4.6% of the PrEP use variance. We observed a greater influence from PrEP intention (aOR = 4.5, 95% CI 2.0–10.1), while there was limited influence from the awareness of PrEP (aOR = 0.4, 95% CI 0.04–4.4). Lower education (aOR = 0.4, 95% CI 0.2–0.9) was negatively associated with PrEP uptake; however, no significant difference was found between middle (aOR = 1.2, 95% CI 0.7–2.0) and high education. We showed that regional differences—MSM in non-urban regions—and other psycho-social determinants account for lower PrEP uptake. Based on these findings, more fine-tuned PrEP access with a focus on non-urban regions can be implemented, and tailored campaigns increasing intention/use can be conducted among target populations.
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spelling pubmed-93158332022-07-27 Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis Wang, Haoyi Shobowale, Oladipupo den Daas, Chantal Op de Coul, Eline Bakker, Bouko Radyowijati, Aryanti Vermey, Koenraad van Bijnen, Arjan Zuilhof, Wim Jonas, Kai J. Int J Environ Res Public Health Article PrEP uptake in the Netherlands is growing but remains at suboptimal levels. Hence, the analysis of hurdles is paramount. Given the initial focus of PrEP provision among men-who-have-sex-with-men (MSM) via a demonstration project that was launched in June 2015, AmPrEP in Amsterdam, and pharmacies in the main urban areas (so called “Randstad”, entailing Amsterdam, Utrecht, Leiden, The Hague and Rotterdam), investigating regional differences is necessary. This study seeks to unravel regional differences jointly with the psycho-social determinants of PrEP uptake. This cross-sectional study included 3232 HIV-negative MSM recruited via the Dutch subsample of the European-MSM-Internet-Survey in late 2017 (EMIS-2017), which aimed to inform interventions for MSM who are highly affected by infections with HIV and other sexually transmitted infections. Prevalence and the standardised prevalence ratio (SPR) of PrEP awareness, intention and uptake were measured on a regional level (Randstad vs. the rest of the country). Multi-level logistic modelling was conducted to identify the association of PrEP uptake with PrEP awareness and intention, socio-demographic, psycho-social determinants and random effects from regional differences. MSM from the Randstad used more PrEP (SPR = 1.4 vs. 0.7) compared to the rest of the country, but there were minor differences for awareness and intention. The regional distinction was estimated to explain 4.6% of the PrEP use variance. We observed a greater influence from PrEP intention (aOR = 4.5, 95% CI 2.0–10.1), while there was limited influence from the awareness of PrEP (aOR = 0.4, 95% CI 0.04–4.4). Lower education (aOR = 0.4, 95% CI 0.2–0.9) was negatively associated with PrEP uptake; however, no significant difference was found between middle (aOR = 1.2, 95% CI 0.7–2.0) and high education. We showed that regional differences—MSM in non-urban regions—and other psycho-social determinants account for lower PrEP uptake. Based on these findings, more fine-tuned PrEP access with a focus on non-urban regions can be implemented, and tailored campaigns increasing intention/use can be conducted among target populations. MDPI 2022-07-20 /pmc/articles/PMC9315833/ /pubmed/35886681 http://dx.doi.org/10.3390/ijerph19148829 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wang, Haoyi
Shobowale, Oladipupo
den Daas, Chantal
Op de Coul, Eline
Bakker, Bouko
Radyowijati, Aryanti
Vermey, Koenraad
van Bijnen, Arjan
Zuilhof, Wim
Jonas, Kai J.
Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis
title Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis
title_full Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis
title_fullStr Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis
title_full_unstemmed Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis
title_short Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis
title_sort determinants of prep uptake, intention and awareness in the netherlands: a socio-spatial analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315833/
https://www.ncbi.nlm.nih.gov/pubmed/35886681
http://dx.doi.org/10.3390/ijerph19148829
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