Objective:
To examine the prevalence and determinants of PrEP surfing among men who have sex with men (MSM) without HIV participating in the Amsterdam Cohort Studies.
Approach:
- Study Design: A prospective study analyzing 2,187 visits from 636 participants between October 2021 and December 2023.
- Definition of PrEP Surfing: PrEP surfing was defined as using a partner’s PrEP use as a perceived HIV prevention strategy during condomless anal sex.
- Data Analysis: Logistic regression was used to assess determinants of recent PrEP surfing, while linear regression assessed intention to practice it.
Key Findings:
- PrEP surfing was reported during 25% of study visits, with 42% of participants reporting it at least once.
- Factors associated with PrEP surfing included number of sex partners, recent PrEP use, recent STIs, and perceived HIV risk.
- Participants aged 45 years and older had lower odds of PrEP surfing compared to younger participants.
- High intention to practice PrEP surfing was reported in 27% of visits, associated with similar factors as recent surfing.
- Intention predicted subsequent PrEP surfing behavior.
Interpretation:
The effectiveness of PrEP surfing for preventing HIV remains unknown and depends on reliable partner disclosure of PrEP use.
Limitations:
- The cohort was predominantly middle-aged MSM with college education, limiting generalizability.
- Frequency of PrEP surfing was not assessed.
- Imputation of HIV perception variables may have affected findings.
Conclusion:
PrEP surfing was practiced by MSM without HIV who did not use daily PrEP. Further research on its effectiveness is needed.
Sources:
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