PrEP eligibility, HIV risk perception, and willingness to use PrEP among high-risk men who have sex with men in India - A cross-sectional survey

Sep 27, 2026

HIV pre-exposure prophylaxis (PrEP) is not yet included in India’s national AIDS program, with demonstration projects for MSM still in planning. To support PrEP rollout for MSM, the study examined associations between guideline-informed PrEP eligibility, HIV risk perception, perceived PrEP benefits and costs, and willingness to use PrEP (WTUP), plus correlates of non-WTUP among PrEP-eligible MSM. Data came from 197 MSM sampled from cruising sites in Mumbai and Chennai. Overall, 76.6% reported they would “definitely use” PrEP, and among those deemed eligible, 79.2% reported WTUP; higher perceived HIV risk and greater perceived benefits related to WTUP, while non-WTUP among eligible MSM linked to low perceived risk and benefits, emphasizing accurate risk assessment and awareness of eligibility criteria.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction

PrEP effectiveness and eligibility context

Prior evidence on awareness and willingness

Risk perception and willingness to use PrEP

AIDS Care Psychological and Socio-medical Aspects of AIDS/HIV ISSN: (Print) (Online) Journal homepage: [https://www.tandfonline.com/loi/caic20](https://www.tandfonline.com/loi/caic20) PrEP eligibility, HIV risk perception, and willingness to use PrEP among high-risk men who have sex with men in India: A cross-sectional survey Venkatesan Chakrapani , Peter A. Newman , Murali Shunmugam , Shruta Rawat , Dicky Baruah , Ruban Nelson , Surachet Roungkraphon & Suchon Tepjan To cite this article: Venkatesan Chakrapani , Peter A. Newman , Murali Shunmugam , Shruta Rawat , Dicky Baruah , Ruban Nelson , Surachet Roungkraphon & Suchon Tepjan (2021): PrEP eligibility, HIV risk perception, and willingness to use PrEP among high-risk men who have sex with men in India: A cross-sectional survey, AIDS Care, DOI: 10. 1080/09540121 .2021.1887801 To link to this article: [https://doi.org/10.1080/09540121.2021.1887801](https://doi.org/10.1080/09540121.2021.1887801) Published online: 21 Feb 2021. | Submit your article to this journal | | --- | | View related articles | | View Crossmark data | Full Terms & Conditions of access and use can be found at [https://www.tandfonline.com/action/journalInformation?journalCode=caic20](https://www.tandfonline.com/action/journalInformation?journalCode=caic20) PrEP eligibility, HIV risk perception, and willingness to use PrEP among high-risk men who have sex with men in India: A cross-sectional survey Venkatesan Chakrapani a,b, Peter A. Newman c, Murali Shunmugam a, Shruta Rawatb, Dicky Baruahb, Ruban Nelsona, Surachet Roungkraphond and Suchon Tepjane aCentre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India; bThe Humsafar Trust, Mumbai, India; cFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada; dFaculty of Science and Technology, Rajamangala University of Technology Phra Nakhon, Bangkok, Thailand; eVOICES-Thailand Foundation, Chiang Mai, Thailand ABSTRACT HIV pre-exposure prophylaxis (PrEP) is not yet included in India’s national AIDS program, with demonstration projects for MSM in planning stages. In order to support PrEP roll-out for MSM, we assessed: (1) associations between guideline-informed PrEP eligibility, HIV risk perception, and perceived PrEP beneﬁts and costs, with willingness to use PrEP (WTUP); and (2) correlates of nonWTUP among PrEP-eligible MSM. Data were collected from MSM (n = 197) sampled from cruising sites in Mumbai and Chennai. More than half (58.4%) reported inconsistent condom use with male partners, 88.3% >1 male partner, and 48.6% engaging in sex work (all past month). Overall, 76.6% reported they would “deﬁnitely use” PrEP. Among 92.9% deemed PrEP-eligible, 79.2% reported WTUP. In adjusted analyses, PrEP eligibility (aOR = 5.31, 95% CI 1.11, 25.45), medium (aOR = 2.41, 95% CI 1.03, 5.63) or high (aOR = 13.08, 95% CI 1.29, 132.27) perceived HIV risk, and greater perceived beneﬁts (aOR = 1.13, 95% CI 1.03, 1.24) were associated with higher odds of WTUP. Among PrEP-eligible MSM, non-WTUP was associated with low HIV risk perception and lower perceived beneﬁts. Facilitating accurate risk assessment and promoting awareness of PrEP beneﬁts and eligibility criteria may increase PrEP uptake among MSM in India. ARTICLE HISTORY Received 19 May 2020 Accepted 1 February 2021 KEYWORDS HIV prevention; preexposure prophylaxis; perceived risk; MSM; India Introduction HIV pre-exposure prophylaxis (PrEP) is safe and highly eﬀective if taken as prescribed (Chou et al., 2019). The World Health Organization (WHO, 2015) recommends PrEP for individuals at “substantial risk”, including men who have sex with men (MSM). India has a concentrated HIV epidemic, with high national HIV prevalence estimates (∼4.3–7.0%) among MSM (National AIDS Control Organisation [NACO], 2015, 2017; Solomon et al., 2015). PrEP demonstration projects in India have been conducted among female sex workers (Reza-Paul et al., 2016, 2019

FAQs

What was the main purpose of the study in India?

To support PrEP rollout for MSM by assessing how guideline-informed PrEP eligibility, HIV risk perception, and perceived PrEP benefits and costs relate to willingness to use PrEP (WTUP), and to identify correlates of non-WTUP among PrEP-eligible MSM.

How were participants and data collected?

Data were collected from 197 MSM sampled from cruising sites in Mumbai and Chennai.

Which factors were associated with higher willingness to use PrEP?

In adjusted analyses, PrEP eligibility and higher perceived HIV risk, as well as greater perceived benefits, were associated with higher odds of WTUP.

Sep 27, 2026

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