Access to subsidised healthcare affects HIV pre-exposure prophylaxis (PrEP) uptake among gay and bisexual men in Australia: results of national surveys 2013-19

Background We assessed willingness to use HIV pre-exposure prophylaxis (PrEP) and current PrEP use among gay and bisexual men (GBM) in Australia. Methods National, online cross-sectional surveys of GBM were conducted in 2013, 2015, 2017 and 2019. Willingness to use PrEP was measured on a previously validated scale. Trends and associations with key measures were analysed using multivariate logistic regression. Results During 2013-2019, 4,908 surveys were completed. Among HIV-negative and untested men not currently using PrEP, willingness to use PrEP increased from 23.0% in 2013 to 36.5% in 2017 (p Conclusion Willingness to use PrEP has plateaued as its use has rapidly increased among GBM in Australia. PrEP use is concentrated among more sexually active men with access to subsidised healthcare. Free or low cost access schemes may facilitate broader access among GBM who want or need PrEP but lack access to subsidised healthcare.