Metrics details. In Benin, men who have sex with men MSM do not always use condoms during anal sex. This study aimed at identifying the potential facilitators and barriers to the use of PrEP. The participants were recruited by the RDS technique respondent driven sampling in six cities of Benin. Logistic regression analyses, adapted to RDS statistical requirements, were performed to identify the factors associated with PrEP acceptability. Mean age of the MSM recruited was PrEP was known by But once well informed, the majority seems willing to use it if made available.
The free availability of the drug and its accessibility in the MSM networks are important facilitators. The possibility of decrease in condom use should not be a barrier to the prescription of PrEP if made available. Peer Review reports. One of the reasons for the high prevalence among MSM may be that anal transmission of HIV without a condom is easier than vaginal transmission without a condom, and individual risks of HIV infection among MSM include unprotected passive anal sex, a high number of male partners, and concurrent injection drug use [ 2 , 3 , 4 ].
In Benin, HIV prevalence was estimated at 7. As observed in other African countries [ 7 ], MSM in Benin are known to be difficult to access because they live in hiding due to the extent of stigma and discrimination against them. They have less access to curative and preventive care services. Behavioural prevention measures regular condom use, abstinence, fidelity and testing have also shown their limitations. In this context of high risk of HIV infection due to the limited means of behavioural prevention, PrEP, integrated to combination prevention programmes, could prove useful in reducing the risk of transmission [ 8 ].
In addition, the scope of PrEP implementation, where available through different programs, appears to depend on its acceptability, the level of knowledge of MSM on this prevention method, as well as on various factors that could influence its use and its impact on risky sexual behaviors.
PrEP acceptability varies across studies, with complex reasons in relation to the individual, the provider, the community and the health system [ 15 ].
