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Healthcare stigma scores impacted preferences among men who have sex with men regarding where they receive long-acting injectable pre-exposure prophylaxis.

Providing multiple location options for accessing long-acting injectable pre-exposure prophylaxis (LA-PrEP) may best meet the needs of men who have sex with men (MSM), according to findings published in the Journal of the International Association of Providers of AIDS Care.

“Given that the study sample was comprised entirely of MSM currently prescribed oral PrEP, and nearly all of them had received PrEP via [a health care provider (HCP)] setting in the past 12 months, it follows that most would prefer what they are used to,” Jennifer L. Glick, PhD, MPH, and colleagues wrote. “However, our findings highlight that among those already connected to PrEP services in an HCP setting, 40% would prefer an alternate setting for LA-PrEP.”

The study included 1,076 MSM who completed the 2021 American Men’s Internet Survey, reported currently taking daily oral PrEP, and expressed interest in LA-PrEP. One of the questions on the survey asked about location preferences for receiving LA-PrEP injections: HCP setting, pharmacy, or at home.

According to the researchers’ findings, 60.4% of respondents preferred an HCP setting for LA-PrEP injections, 25.9% preferred being at home, and 13.7% preferred a pharmacy.

Factors Affecting Location Preferences

Adjusted models showed that high healthcare stigma scores, which considered both anticipated and actual MSM-related stigma, were associated with a pharmacy or home preference rather than an HCP setting. Meanwhile, actual stigma experiences involving friends and family were linked with a preference for receiving LA-PrEP in an HCP setting over a pharmacy.

“This preference away from pharmacies may be due to their inherently public nature, where one might be more likely to be seen by friends or family,” Dr. Glick and colleagues wrote.

Healthcare access history and younger age (25-29 or 30-39 years vs 40 years and older) were associated with a preference for an HCP setting over being at home. Respondents with private insurance were more likely to prefer an HCP setting or a pharmacy than to stay at home.

“These findings suggest that MSM not currently utilizing PrEP might also be interested in care setting alternatives, although future research is needed to confirm this hypothesis,” the researchers wrote. “Nonetheless, our findings highlight the utility of diverse PrEP service delivery locations in improving PrEP access for MSM.”