Exploring determinants of pre-exposure prophylaxis awareness and willingness among sexual minority men in Taiwan: a stochastic search variable selection approach.

Abstract

Since the introduction of pre-exposure prophylaxis (PrEP) in Taiwan in 2016, understanding factors influencing awareness and willingness among sexual minority men (SMM) remains critical. This study investigated predictors of PrEP awareness and willingness among SMM in Taiwan. A cross-sectional online survey conducted between April and May 2023 included 379 HIV-negative or status-unknown cisgender men identifying as gay, bisexual, or men who have sex with men, aged 18-59. Using stochastic search variable selection (SSVS), regression models identified key factors associated with PrEP awareness and willingness. Results revealed high awareness (96.9%) but moderate willingness (75.5%) to use PrEP. Regular HIV/STI testing, using apps to find sex partners, and community affinity significantly predicted both awareness and willingness. Additionally, internalized stigma, higher education, financial stress, and sexualized substance use were linked to awareness, while enacted stigma and PrEP awareness were associated with willingness. These findings highlight the need for targeted strategies to address stigma and barriers to awareness and willingness. Leveraging digital platforms and fostering community engagement are essential for strengthening these critical precursors in HIV prevention among SMM in Taiwan.