Gay men’s attitudes to and perceptions of pre-exposure prophylaxis (PrEP) and post- exposure prophylaxis (PEP) Question What are gay men’s attitudes to and perceptions of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)? Key Take-Home Messages

 There were fewer studies published on the potential use of nonoccupational PEP (nPEP) among men who have sex with men than those on PrEP.  Although 47% to 64% of men who have sex with men were aware of nPEP, fewer than 5% had used nPEP (1-3).  The proportion of men who have sex with men aware of PrEP ranged from 13% to 64% (2;4-8), but reported use of PrEP was much lower: from 0.4% to 2% (4-6;8). Men were more likely to be aware of PrEP if they: had a high numbers of sexual partners; and had a care provider who was aware of their sexual behaviours (2;6).  The proportion of men who have sex with men who were interested in using PrEP ranged from 40% to 79% (4;5;7-10). Men were more likely to be interested in using PrEP if they were involved in high-risk activities (5-8;1113), such as greater numbers of sexual partners and participating in unprotected anal sex with casual partners.  The primary concern about using PrEP was a false sense of security, which could lead to increased risk compensation (5;12;14), particularly through decreased use of condoms during intercourse. Other perceived challenges to PrEP adoption included cost and accessibility of the medication, side effects, and adverse effects of irregular PrEP use (14).