Factors Affecting the Intention to Take Non-occupational HIV Post-exposure Prophylaxis Among Thai Men Who Have Sex With Men

This study design is mixed-method, starting with quantitative research and followed by qualitative research. The study will be conducted in 2 phases: a cross-sectional study during phase I and a prospective descriptive study during phase II, which will use qualitative research techniques to help understand and define obstacles and uncover opportunities to improve adherence to post-exposure prophylaxis.

During phase I, this study is a quantitative research study using a cross-sectional study design which aims to enroll 450 men who have sex with men (MSM) within 6 months and to collect data by administration of questionnaire amongst all MSM via face-to-face interview. During phase II, we will use a quantitative research design and perform in-depth interviews with those MSM who choose to receive and choose not to receive nPEP despite the fact that they meet nPEP criteria. We expect to identify approximately 50 MSM who meet nPEP criteria during the enrollment period. The number of volunteers will be determined based on saturation theory in which the data collection will be considered complete after analysis of the data shows that additional entries provide no further information (64). The number of volunteers in phase II may not be able to be specified with certainty in advance. Enrollment of subjects will stop once data acquisition is saturated.

An initial review of demographic data and sexual behavior amongst MSM seen at the TRC-ARC will be undertaken by interviewing the TRC-ARC staff who are responsible for looking after this population. This process will aid understanding of clinic logistics and help identify opportunities to meet with MSM individuals. The potential participants will be informed of the study details, including the study objectives. Once they have read the study information sheet and have a good understanding of the study, those who intend to participate in the study will be asked to sign the consent form for this study. There are 2 groups of participants: MSM who seek HIV voluntary counseling and testing service (phase I) and MSM who meet nPEP criteria (phase II).

Phase I. MSM who seek HIV voluntary counseling and testing

1. All MSM clients will be interviewed to complete the questionnaires designed to collect information for this study before the pre-test counseling. The questions will collect demographic data and data regarding HIV risk behaviors, HIV knowledge, intention to take nPEP, factors affecting the intention to take nPEP, experience on nPEP use, and awareness of nPEP.
2. After MSM clients receive the counseling. They will be interviewed to answer the questionnaires about HIV knowledge, intention to take nPEP, factor affecting to intention to take nPEP, nPEP knowledge.
3. All MSM clients will receive pre-test counseling, HIV testing, and post-test counseling according to the standard of care at the Anonymous Clinic, TRC-ARC. Counselors will also assess clients for nPEP eligibility criteria according to the standard clinic guidelines.