HIGH ACCEPTABILITY OF LONG-ACTING INJECTABLE PrEP AND ART AMONG MSM AND PWID IN INDIA - Study report

Sep 27, 2026

Uploaded by acoobca

Long-acting injectable pre-exposure prophylaxis (LA-PrEP) and long-acting antiretroviral therapy (LA-ART) are evaluated for acceptability among men who have sex with men (MSM) and people who inject drugs (PWID) in India. Respondent-driven sampling recruited community-based samples across multiple sites (Nov 2022–Jan 2024), using interviewer-administered surveys and blood draws. High willingness was observed, yet vulnerable subgroups may need tailored prevention and treatment implementation. Reasons for unwillingness included cost, injection-related side effects, and concerns about effectiveness.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Objective

Methods

Results

Limitations

Conclusions

Acknowledgements

HIGH ACCEPTABILITY OF LONG-ACTING INJECTABLE PrEP AND ART AMONG MSM AND PWID IN INDIA 1243 Allison M. McFall 1 , Talia A. Loeb 1 , Jiban J. Baishya2 , Ashwini Kedar3 , Archit Sinha 3 , Aylur K. Srikrishnan4 , Sunil S. Solomon 1 , Gregory M. Lucas 1 , Shruti H. Mehta 1 1 Johns Hopkins University, Baltimore, MD, USA; 2 Johns Hopkins University, New Delhi, India, 3YR Gaitonde Centre for AIDS Research and Education, New Delhi, India, 4YR Gaitonde Centre for AIDS Research and Education, Chennai, India BACKGROUND • Long-acting injectable pre-exposure prophylaxis (LA-PrEP) and antiretroviral therapy (LA-ART) hold significant potential to overcome challenges of daily adherence to oral modalities • Population-level impact of LA-PrEP and ART requires acceptability and uptake among those with a high burden of HIV such as people who inject drugs (PWID) and men who have sex with men (MSM) OBJECTIVE • To characterize acceptability and correlates of LA-PrEP and LA-ART among community-based samples of MSMand PWID in India METHODS • Respondent-driven sampling (RDS) of PWID and MSMacross 5 PWID sites and 2 MSM sites (750/site) Nov 2022-Jan 2024 • Inclusion criteria: 1) ≥18 years old and 2) injection drug use in the prior 2 years (PWID) OR 2) sex with a man in prior year (MSM) • Interviewer administered survey and blood draw • LA-PrEP questions for those with no prior HIV diagnosis and LA-ART questions for those with a prior diagnosis • Acceptability and reasons for unwillingness to use LAPrEP/ART summarized • Correlates of willingness explored using multilevel multivariable logistic regression models RESULTS | Table 1 Population characteristics | | | | --- | --- | --- | | n (%) or median (interquartile range) | PWID (N=3750) | MSM (N=1499) | | Age (years) | 28 (24 – 33) | 28 (24 – 37) | | Male sex | 3641 (97) | 1499 (100) | | Recent daily injection drug use | 2404 (58) | 0 | | Recent sharing needles/syringes | 1789 (50) | 0 | | Recent unprotected sex* | 1251 (30) | 452 (41) | | Previously heard of PrEP | 196 (5) | 287 (21) | | Living with HIV | 1310 (40) | 283 (21) | | Diagnosed | 583 (37) | 189 (68) | | Currently on antiretroviral therapy (ART) | 473 (29) | 180 (65) | | HIV viral load>150 copies/mL | 413 (66) | 69 (25) | | *Partner of any gender for PWID; anal sex with man/transgender person for MSM; Recent=in prior 6 months | | | High interest in LA-PrEP and LA-ART among key populations – however, vulnerable subgroups may require other prevention and treatment approaches Figure 1 Willingness to use LA-PrEP Figure 2 Willingness to use LA-ART Figure 3 Correlates * of willingness to Figure 3 Correlates * of willingness to use LA-PrEP Ref. 18-25 yrs 26-35 yrs 36-45 yrs 46+ yrs Female sex Currently married Homeless Daily drug injection Shared needles Hazardous drinking Ref. no sexual 1 partner partners 2+ partners Unprotected sex Ref. 18-25 yrs 26-35 yrs 36-45 yrs 46+ yrs Currently married Hazardous drinking Ref. no sexual partners 1 partner 2-5 partners 6-15 partners 16+ partners Unprotected anal sex | Table 2 Reasons for unwillingness to use LA-PrEP | | | | --- | --- | --- | | n (%) | PWID (N=440) | MSM (N=487) | | Side effects (excluding pain) from injections | 110 (31) | 92 (24) | | Cost | 82 (22) | 205 (42) | | Diet or sleep might be interrupted | 114 (30) | 53 (13) | | I am not at risk for HIV | 128 (26) | 43 (9) | | Worry injections won’t work | 108 (26) | 67 (15) | | It is a hassle to get injections | 135 (23) | 40 (11) | | Drug resistance might develop | 68 (14) | 53 (14) | | I do not like taking injections | 56 (12) | 50 (10) | | Table 3 Reasons for unwillingness to use LA-ART | | | | --- | --- | --- | | n (%) | PWID (N=62) | MSM (N=18) | | Worry injections won’t work | 21 (44) | 6 (35) | | Side effects (excluding pain) from injections | 19 (29) | 8 (43) | | It is a hassle to get injections | 15 (21) | 5 (21) | | Pain from the injection | 12 (15) | 10 (54) |

FAQs

What was the study objective regarding LA-PrEP and LA-ART?

To characterize acceptability and identify correlates of LA-PrEP and LA-ART among community-based samples of MSM and PWID in India.

How were participants recruited and what measurements were used?

Participants were recruited using respondent-driven sampling across designated PWID and MSM sites, followed by interviewer-administered surveys and blood draw procedures.

What reasons were most commonly reported for unwillingness to use LA-PrEP?

Common reasons included cost, injection-related side effects (excluding pain), disruption to diet or sleep, and concern that injections would not work.

What did the study conclude about willingness to use long-acting injectable modalities?

The study concluded that willingness to use long-acting injectable PrEP and ART was high among PWID and MSM in India, while emphasizing the need for further exploration of implementation strategies, especially in low-resource settings.

Sep 27, 2026

Uploaded by acoobca