Biomedical research demonstrating the benefits of taking HIV treatment to prevent HIV transmission (known as treatment as prevention, or TasP) has developed substantially in recent years. We are now able to say with confidence that an HIV-positive person who takes antiretroviral treatment (ART) and maintains an undetectable viral load cannot pass HIV to a sexual partner. This represents a major breakthrough in the field of HIV, both for its prevention implications and for its potential to reduce stigma faced by people living with HIV. However, when a health innovation like this emerges, it can take time for the information to reach the communities who would most benefit from it. Gay, bisexual and other men who have sex with men (MSM) represent over half of people living with HIV in Canada, so this community stands to benefit from using TasP as a highly effective strategy for HIV prevention.
The study
A study called the Momentum Health Study looked at perceptions about TasP in a total of 774 MSM in Vancouver (556 were HIV negative or had an unknown HIV status, and 218 were HIV positive). The study tracked participants’ beliefs about TasP between 2012 and 2016. Research about TasP was accumulating during this time period, with two major studies releasing their final results in 2016.
In the Momentum study, men filled out the same survey up to seven times, at 6-month intervals. The survey asked respondents:
- whether they had heard of TasP, and if they believed it was effective
- demographic and lifestyle questions
- questions about their sexual practices and substance use
Findings
Awareness and perceptions of TasP
Each time a participant filled out the survey, they were grouped into one of three classes based on their answers to a series of questions about TasP:
- Unaware: They had not heard of TasP
- Skeptical: They had heard of TasP but were not confident that it was effective
- Believing: They believed that TasP was effective
At the beginning of the study, HIV-positive men were more aware of TasP compared to HIV-negative men. At their first time filling out the survey, 44% of HIV-positive men believed in TasP, 22% were skeptical that it was effective, and 33% were unaware of TasP. When HIV-negative men first filled out the survey, only 4% believed that TasP was effective, 23% were skeptical of TasP, and almost three quarters (74%) were unaware of TasP.